Dear all

Responding to the post on the 6 month old who had a patch on his face which then spread and got all crusty and oozy, and was managed by allergy consultations ( no effect after 6 weeks) and so on.

Here is an alternative view...

This really sounds like "school sores"  to me, an infection with staphylococcus  that should be treated with antibiotics.

It should be treated because
a. It can spread quite fast and get extensive
b antibiotics work (either flucloxacillin orally or mupirocin topically) and will clear it up quickly in a matter of days.
c If it gets extensive it can makes kids sick and miserable and  get further infected by other bugs
d It can be spread to others, especially other kids
e. You will know pretty quickly if it is school sores as it will respond fast.

I think there are a few really good reasons to use antibiotics in kids and this is one of them. Also, I am a bit dubious about allergy testing for something like this - the risk is that you may actually find some "positive allergy" on a test that actually has nothing to do with the clinical problem and then doom either a child or a breastfeeding mother to a restrictive diet for months or a life time. This to my mind is much worse than a short course of antibiotics, even for a 6 month old and especially if there is a topical antibiotic that can avoid the diarrhoea problems you sometimes get. 

I have seen many mothers and children with one restrictive diet added after another when the real clinical problem was actually quite simple. The end result is that they are on a bizarre, unhealthy and unbalanced diet and labelled for life. I am very very cautious indeed about interpreting allergy tests without a lot of thought..

Mary E Black
Professor of Public Health
Dept of Social and Preventive Medicine
North Queensland Clinical School
PO box 1103 Cairns QLD 4870

Tel 61 740 503670
Fax 61 740 514 322
E-mail [log in to unmask]