could this be from a staph skin infection?!?! need help by a.m

[eljomom]

Wow--again! I keep turning up more info, and now have more questions. I've posted about my daughter (6) who suddenly developed tics (many!) within a week of a fever. never tested for strep, and it was less than 24 hours and she was fine again. has always had some mild ocd and one or two mild tics, but within a week of the fever, exploded.

so it's been 3 months, and i'm taking her in tomorrow for a skin infection. She had it first in my family back in July, I think (after the fever/tics started). I kept puttiing neosporyn on it, and it took a few weeks, but it went away.. My 11 year old son then got it in a number of spots (from bug bites???), and he finally had to take an antibiotic. then my 8 year old got the skin infection...antibiotics. then my 11 year old again...antibiotics again. They cultured my 11 year old the first time he had it, and it was staph, not strep. but now I just read here that impetigo can cause pandas???? wondering if this could be impetigo? but mainly, can the staph be exacerbating things?? still wondering the best antibiotic (hoping my ped. will listen to my suggestion) that would kill the staph AND fight the pandas....

going for an early apt. tomorrow then camping, so if anyone can reply asap--would appreciate the wisdom. thanks!

[matis_mom]

Wow--again! I keep turning up more info, and now have more questions. I've posted about my daughter (6) who suddenly developed tics (many!) within a week of a fever. never tested for strep, and it was less than 24 hours and she was fine again. has always had some mild ocd and one or two mild tics, but within a week of the fever, exploded.

so it's been 3 months, and i'm taking her in tomorrow for a skin infection. She had it first in my family back in July, I think (after the fever/tics started). I kept puttiing neosporyn on it, and it took a few weeks, but it went away.. My 11 year old son then got it in a number of spots (from bug bites???), and he finally had to take an antibiotic. then my 8 year old got the skin infection...antibiotics. then my 11 year old again...antibiotics again. They cultured my 11 year old the first time he had it, and it was staph, not strep. but now I just read here that impetigo can cause pandas???? wondering if this could be impetigo? but mainly, can the staph be exacerbating things?? still wondering the best antibiotic (hoping my ped. will listen to my suggestion) that would kill the staph AND fight the pandas....

going for an early apt. tomorrow then camping, so if anyone can reply asap--would appreciate the wisdom. thanks!

My PANSAS son reacted when her sister had impetigo. Impetigo could be staph or strep, and they can swab and test to see which. My daughter's cleared right away on Muciporicin ointment (it's a prescription cream), but she is not the PANDAS child, so that was ok, but if it's your PANDAS child and he is not on anything now, I would definitely insist on oral antibiotics (not sure which one would cover staph)

[Stephanie2]

Well in our experience, ds2 got a staph infection back in january and it created VERY BAD pandas symptoms. I don't know, I still wonder if there was some strep in there b/c he was psychotic! Augmentin cleared up the impetigo and also the pandas symptoms within 2-3 days, but after 2 weeks of augmentin, it would always come back!! He must have done 5-6 rounds of augmentin to finally kill it this past august. I don't know if it was one long bout of impetigo or if he just kept getting it b/c he has eczema. I do think we finally got it, though. In the end, I had to do a 20 day steroid taper to get rid of the last of the OCD.

 

I hope you are able to get on top of it! It's a killer!! Ugh! I really stay on top of controlling his eczema now that I know how easily a bacterial infection can set in...

 

And yes I do think that DS5's pandas symptoms were affected by DS2's impetigo...

 

Let us know what happens!

[eljomom]

Stephanie thanks for your reply...I noticed your signature line, and wondered if there was anything from the pandasnetwork group that I might be able to give my pediatrician to bring him up to speed. I mentioned her sudden symptoms a month after they started, when I was in for my 11yr. old's skin infection, and he said "the boy in here before you has TS and mom runs him in every time his tics "wax" for a throat culture.." with a tone like he thought it was nonsense. Then he swabbed my daughter---which was negative (nurse told me results) and that was the end of it. No titers, etc. Now were 3 months out and i'm not sure it's even worth running titers, as this may all be from a pandas reaction earlier in her life (I never take her to the doc...very rarely....just let everything run it's course), where the one night fever wasn't strep at all, just a virus (many kids had it), so why even run titers???

 

 

Well in our experience, ds2 got a staph infection back in january and it created VERY BAD pandas symptoms. I don't know, I still wonder if there was some strep in there b/c he was psychotic! Augmentin cleared up the impetigo and also the pandas symptoms within 2-3 days, but after 2 weeks of augmentin, it would always come back!! He must have done 5-6 rounds of augmentin to finally kill it this past august. I don't know if it was one long bout of impetigo or if he just kept getting it b/c he has eczema. I do think we finally got it, though. In the end, I had to do a 20 day steroid taper to get rid of the last of the OCD.

 

I hope you are able to get on top of it! It's a killer!! Ugh! I really stay on top of controlling his eczema now that I know how easily a bacterial infection can set in...

 

And yes I do think that DS5's pandas symptoms were affected by DS2's impetigo...

 

Let us know what happens!

[airial95]

eljomom,

 

Mati's mom is correct, impetigo can be caused by staph or strep. My son's PANDAS was triggered by an impetigo infection - not strep throat. When either of my kids had impetigo (my daughter has had it twice) - he's always used Altabax ointment (rx) as well as oral antibiotics (Biaxin I believe - but I can't be sure). Since my son's PANDAS - whenever he has gotten strep, or is exposed, our dr also has us swab muciroprin (sp?) ointment in the inside of the nostrils, since the bacteria can "hang out" there and oral abx won't catch it. He also recommended the whole family do that to help prevent us being carriers.

 

Hope this helps!

[colleenrn]

It sounds like impetigo, especially since all your kids have it. It is very contagious. It could be from staph, strep, or both. Regardless, it needs to be treated with oral and topical antibiotics.

[eljomom]

It was impetigo....guessing staph since that's what son swabbed for over the summer, and theyve been passing it around. although he said it could be strep too. he said Keflex would be good, and I asked about Augmentin, he said fine.

Wouldn't do titers...said I had to see a neuro b/c he doesn't test for stuff he doesn't really buy into or understand:(

 

It sounds like impetigo, especially since all your kids have it. It is very contagious. It could be from staph, strep, or both. Regardless, it needs to be treated with oral and topical antibiotics.

[Stephanie2]

Stephanie thanks for your reply...I noticed your signature line, and wondered if there was anything from the pandasnetwork group that I might be able to give my pediatrician to bring him up to speed. I mentioned her sudden symptoms a month after they started, when I was in for my 11yr. old's skin infection, and he said "the boy in here before you has TS and mom runs him in every time his tics "wax" for a throat culture.." with a tone like he thought it was nonsense. Then he swabbed my daughter---which was negative (nurse told me results) and that was the end of it. No titers, etc. Now were 3 months out and i'm not sure it's even worth running titers, as this may all be from a pandas reaction earlier in her life (I never take her to the doc...very rarely....just let everything run it's course), where the one night fever wasn't strep at all, just a virus (many kids had it), so why even run titers???

 

 

Well in our experience, ds2 got a staph infection back in january and it created VERY BAD pandas symptoms. I don't know, I still wonder if there was some strep in there b/c he was psychotic! Augmentin cleared up the impetigo and also the pandas symptoms within 2-3 days, but after 2 weeks of augmentin, it would always come back!! He must have done 5-6 rounds of augmentin to finally kill it this past august. I don't know if it was one long bout of impetigo or if he just kept getting it b/c he has eczema. I do think we finally got it, though. In the end, I had to do a 20 day steroid taper to get rid of the last of the OCD.

 

I hope you are able to get on top of it! It's a killer!! Ugh! I really stay on top of controlling his eczema now that I know how easily a bacterial infection can set in...

 

And yes I do think that DS5's pandas symptoms were affected by DS2's impetigo...

 

Let us know what happens!

 

We don't have a flyer or brochure yet but Lynn is working on it. What I do is print out the page titled "healthcare provider info". Your ped sounds like a real pain...My ped buys into it and I think she thinks that MAYBE my 5yo has it, but she fights me regarding my 2yo (who recently had sudden onset OCD/psychosis and I brought him in based on that alone to test for strep and it was positive - then got better after 48 hours of augmentin - and she STILL questioned his dx!!! maddening! I swear I am going to get him on video next time it happens!). Luckily we have a separate doc for pandas.

[3boysmom]

We just got back from Maryland where we saw Dr. L. for our PANDAS son. After discussing the ds10 and his PANDAS we mentioned the 2 brothers (almost 8 and the other 9.) Mentioned that the 9 year old son has eczema and soars in the nose that never heal (also got HSP) at the same time as ds10 got PANDAS. Mentioned that the 8 year old has head tics that have gotten worse when this all began with ds10. Unfortunately, she confirmed that the sibling rate is very high....we will get Cunningham tests for all 3 boys. I did want to mention that she suggested Bleach baths for the boys. She said to put a half or quarter cup of bleach in the bath water and that it was great to kill staph or strep (on the skin or else where) she said that it helps to get in their sinus cavities when breathing in during the bath. I Google it and the research I read did absolutely confirm what she said. I am off to buy stock in Bleach.

[eljomom]

Very interesting! So have you done any other tests? Is Cunningham going to be the first one? The ASO and antiDNaseB seem so iffy that I almost feel like "why bother?" If they're high, it might not even mean pandas, because normal kids can be elevated after strep, and if it's low, sometimes pandas kids have low titers!!

 

 

We just got back from Maryland where we saw Dr. L. for our PANDAS son. After discussing the ds10 and his PANDAS we mentioned the 2 brothers (almost 8 and the other 9.) Mentioned that the 9 year old son has eczema and soars in the nose that never heal (also got HSP) at the same time as ds10 got PANDAS. Mentioned that the 8 year old has head tics that have gotten worse when this all began with ds10. Unfortunately, she confirmed that the sibling rate is very high....we will get Cunningham tests for all 3 boys. I did want to mention that she suggested Bleach baths for the boys. She said to put a half or quarter cup of bleach in the bath water and that it was great to kill staph or strep (on the skin or else where) she said that it helps to get in their sinus cavities when breathing in during the bath. I Google it and the research I read did absolutely confirm what she said. I am off to buy stock in Bleach.

[momto2pandas]

My boys had impetigo last month, while they were on azith. I asked their immunologist about switching to Augmentin, but he said that he would not expect Augmentin to be very effective against impetigo. He switched both boys to penicillin, which I was very skeptical about because it doesn't have the same antiinflammatory effects as azith or Augmentin, but I'll be damned if it didn't clear up the impetigo. We also used the Muciporicin ointment. The immunologist also upped their IVIG that round to 1 g/kg instead of 0.75, for extra support. Whatever it was, both boys got rid of the impetigo and back to 100% very quickly. Ds7 had started to get some PANDAS symptoms while he had the impetigo, but we only had one really bad day before the penicillin kicked in. Ds4 never did really get his OCD-PANDAS thing with the impetigo, but he was very fatigued.

 

They had also both been having digestive problems along with the impetigo - one constant diarrhea, the other constipation. The switch to penicillin cleared them both of that, making me wonder if azith had started to wreak havoc on their guts. Either that or the autoimmune reaction to the strep or staph was affecting their guts via effects on their neurotransmitters - probably the most likely explanation.

 

Interestingly, their immunologist spotted ds7's impetigo right away even though it was inside his nose. Ds7 had had "crusty nostrils" a bunch in the past - the pediatrician, and my GP, and Dr. B all mentioned it during exams at the beginning of the year -- but none of them said that it was impetigo. I guess it helped that ds4 had it on his face and legs when ds7 had it in his nose this time. The immunologist also probably sees it a lot more often. Also, they both were having lots of nosebleeds, which I guess was related to the intra-nostril impetigo.