>>On the information available it appears to be bacterial involvement
however I missed the initial posting -

>>Was there a Dx ultrasound performed?<<

No, those are not generally done here.

>>Is the flushing that remains still bilateral?<<

I have not seen mom so far this week, but she reports that the flushing
remains, mostly on the left breast, not so much the right.

>>Did she ever suffer any systemic symptoms?<<

She never went fully systemic-- just greater breast involvement.

>>Augmentin seems an odd choice of treatment, however I am surprised that
Keflex has not had any effect if there is bacterial involvement, as this is
a good broad spectrum drug for mastitis. However as superantigens have been
identifed in some mastitis isolates (and can interfere with normal immune
responses) it is possible that this women may need a good 10-14 day course
followed by a lower dose for another couple of weeks. How long a course did
she take of the Keflex? Does her sensitivity(?) to Ibuprofen extend to all
NSAIDS?<<

I've suggested to mom that she see about getting a one week trial of
Dicloxacillin. Baby's culture was totally clean, mom's milk grew something
staph that a ped considered to be due to skin contamination.  I told mom she
may need long term low dosing, but she said NO WAY, she's been there before
with her bladder and doesn't want to repeat, as it had thrown her into deep,
chronic yeast problems. She will not take other NSAIDS, either.

Cathy, thanks for your feedback. I will be seeing the mom for myself this
week (she lives a ways away) and hope to gain some more info by then.

Lisa Marasco IBCLC

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