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Mario is a four month old boy who is bought in to the GP by his concerned mother. She has noticed a white plaque on the inside of his mouth since last night. Fortunately, he is feeding well (fully bottle fed) and does not appear to be bothered by this. She denies any fevers and says he is well otherwise. He was born at term with no complications and had a normal vaginal delivery.

On examination his observations are normal, and you note a 2cm x 2cm white plaque on the roof of his mouth. You notice this gently sloughs off with pressure from a cotton bud and prescribe Miconazole gel for a week. A week later although it has been some benefit, you agree at his review that the area has not resolved.

Based on the likely diagnosis, what would be the most appropriate management at this stage?

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