Child with persistent swelling on chin with redness followed by swelling on forehead, under the eyes with tiredness. No improvement with Zyrtec. What is the cause?
Patient: my 6 year old woke 2 days ago with a red forehead and chin . by that night it looked slightly swollen so we took him to the doctors. he said it looked like a reaction to something and gave him claratyne to take. today the redness is worse and swelling is too. his forehead nose and under eyes swollen. back to the doctors we went and he told us to take Zyrtec. He has had two doses of that and tonight still looks like the swelling is getting worse? Is this just a reaction to something or is it something else. He is showing no other symptoms but being a little tired Doctor: it is acute sinusitis which is allergicactually this is coomon to develop in children any timeit is mostly milk induced as the child ned milk for 2 years only breast and after that  no milkas we add milk and diary in diet these causes allergy and vaious diseases as they are animal proteins incompetible with hbuman proteinsfor time add metronidazole 200 mg bd for 5 days as it clear sinuses quicklyadd antiallergic fexofenadine 30 mg bdsyp cpm 1 tsf nightapply local antibiotic mixed with antiallergic ointment in affected partsadd liquid antacidmefanic acid sos for pan or feverwithdraw milk and diary from diet for next some years