Question: My 8.5 yo has had a chronic sickly sweet smell from her nose, drainage, and occasional nose bleeds. I would say she has had it for at least 3-4 years, ever since we adopted her from China. She was born with a bilateral cleft lip and palate, which has been repaired by the craniofacial team at Fairfax Inova, and last summer she underwent an alveolar bone graft, which was recently determined to have failed, perhaps due to infection; Dr. Baker is not sure. Her younger sister and I keep (2-3 times in a 12-month period) getting strep throat and, each time we get it, I ask for 8yo to be tested too just in case, and she will come up positive. We will all be treated with amoxicillin or cephalexin. Younger daughter and I got better. Just this past time, I started to put two and two together and realized older daughter's smell went away while she was on the antibiotics, but I swear it is back again. It has been 2 days since she finished the antibiotics. What is going on! Does she have strep/impetigo in her nose? If so, how do we clear it up? Could this have caused or at least contributed to the alveolar bone graft failure last summer? Her next one is scheduled for this July and I must get all these questions answered and this situation cleared up before that. I will not put her (and all of us) through this again if I can not figure this out! It is also starting to get embarrassing for her because her friends are starting to tell her she smells. :( (And I cannot blame them, because, yes, she does smell, no matter WHAT we do: brush, floss, mouthwash, nasal rinse, nasal gel, sinus rinse, all of the above done at school at recess after lunch time, also in the mornings and evenings, etc.). WHAT is going ON?!?!?!?! : (

Thank you. Each time my younger daughter and/or I test positive for strep (we go in because we feel terrible and have all the classic strep symptoms), I ask for older daughter to be cultured too, and, sure enough, she is positive, despite no regular strep symptoms (she always has lots of energy, no sore throat, no fever, no swollen tonsils, no white spots on tonsils, etc.). So, it has been a mystery and our pediatrician has speculated she is a "carrier." But what I am beginning to think is: she is not a *carrier;* she in fact *is* infected (chronically), but it is in her *nose,* thus the bad smell, the runny (persistent and smelly) discharge, and the nosebleeds (and, the failed alveolar bone graft last summer). So, basically, are you saying this is a perfectly valid and possibly correct hypothesis, and, to test it out, I should ask for an MRI of face and sinuses? We have an appt. with pediatrician on Friday so I want to make sure I am on the right path. Even though I, though well educated, am not medically trained and have only put these pieces together myself through a lot of research and hypothesizing. Thank you.