> 
>If we culture nothing of significance, what next? Could she "just" be
>sensitive? But if so, why the slightly visible redness if it isn't a mild
>chronic mastitis?  Why did most but not all clear up?  I'm not sure where we
>should go next....... suggestions?

Even if you don't get a positive culture this doesn¹t mean that there is not
microbial involvement as you cannot be sure that you have expressed a sample
from the site of the breast involved. On the information available it
appears to be bacterial involvement however I missed the initial posting -
Was there a Dx ultrasound performed?
Is the flushing that remains still bilateral?
Did she ever suffer any systemic symptoms?
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?

Regards
Cathy Fetherston

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