Found my strep carrier!

[thereishope]

What I meant by "basic" antibiotics is that my kids, who do not get any symptoms of strep, clear on 10 days of amoxicillin. And, yes, I know that is a rarity on here.

 

I suppose it may not matter if someone is catagorized as an actual carrier or just someone who does not get symptoms. Does it? Unless, you have a doctor that stands by the idea that carrier does not have to cleared.

 

I'm sorry but I didn't read all the responses first. The non-PANDAS child that you say is the strep carrier, did they test + multiple times? All 3 of my kids (only one is PANDAS) do not get symptoms of strep when they have strep, yet they are not carriers. I think it's determined the person is a carrier when they have no symptoms AND basic antibiotics don't clear the strep.Did someone mention to retest your kids 3 weeks after finishing meds?

 

Yeah...I don't actually know if there is real clarity (among the medical profession) as to what constitutes a strep carrier.

 

It is my understanding, that a "normal" person will clear strep (even without antibiotics) within a couple of weeks (read that somewhere, sorry, don't remember where). So, I think one definition could be someone that

1) is assymptomatic

2) is positive for strep longer term (more than 2 weeks)/doesn't clear naturally

 

I'm not so sure about not being cleared with basic antibiotics (do clindamycin and Azith. count)? It is my impression that carriers may be more difficult to clear (b/c they are not mounting an immune response against strep) than an average person but it is definitely possible.

 

Ed Kaplan did mention at one point that he would consider our PANDAS dd to be a strep carrier...even though she had initial (FEVER) symptoms of strep, the fact that she was still positive 2 mo. later made him consider her a carrier. (Never mind whether she eventually cleared with antibiotics).

 

But, I think that the definition of "strep carrier" remains a little fuzzy....kind of annoying that people toss those words around so much as it means different things to different docs.

 

And should a carrier have high strep titers or low? I don't think that one is known either.

Edited September 29, 2010 by Vickie

[momcap]

And should a carrier have high strep titers or low? I don't think that one is known either.

 

Of my 2 boys that doc calls carriers the PANDAS one has high ASO - 512, and the hopefully non-PANDAS one was normal. Who knows. Someone needs to do a study!

[EAMom]

Thanks for all the replies! I read on another topic to re-test after 3 weeks. Our doctor wants to see just the PANDAS son 1 week after. I can't seem to make her understand our predicament. So I'm going to book appts for both boys in 3 weeks anyway. I also suspect that amoxicillin is "lame" and it won't clear the strep. But the doctor didn't want to treat with anything, saying that carriers are not treated. I had to beg for anything. I think we've been dealing with this same strep for several years and we've been on amoxicillin so many times, but it never clears anything. We've also been on zithromax repeatedly, so I would guess this is a resistant strain. My doctor was not open to my suggestion of augmentin or clindamycin.

 

 

Hmmm. Might be time to find a new doc!

 

She is right in that carriers aren't "normally" treated (Oh, but I see she said carriers are not treated, period. UGHH). But, there are definitely ("abnormal") situations where a carrier should be treated. A non-PANDAS example would be if a carrier is constantly re-infecting a member of the household (or if a member or a household has, say rheumatic fever). And if there is PANDAS in the family, all carriers should definitely be treated!

 

This article might help your case http://www.jfponline.com/pdf%2F5710%2F5710JFP_ClinicalInq1.pdf ...but part of me is inclined to say, if you need to fight your doc on this simple topic, you aren't going to get far with her when things get more complicated!

 

I should also add that the carrier state remains "an enigma" and the medical profession has long held the assumption that it is benign (being a strep carrier), when we don't actually know that is the case.

[momcap]

 

Hmmm. Might be time to find a new doc!

 

This article might help your case http://www.jfponline.com/pdf%2F5710%2F5710JFP_ClinicalInq1.pdf ...but part of me is inclined to say, if you need to fight your doc on this simple topic, you aren't going to get far with her when things get more complicated!

 

 

Thank you for the article! I've been googling strep carrier treatment and haven't found anything very useful yet. I agree that I need a different doctor, but I'm stuck between a rock and a hard place. We are driving almost 2 hours each way to see our family doctor in a city we haven't lived in for almost 15 years. We have been unable to get a doctor in each of the 3 cities we have lived in since then because our whole country (Canada) is facing a major shortage of doctors. In our current town everybody uses the Emergency Room like a clinic because hardly anyone has a doctor at all. We are anticipating going to one of the PANDAS doctors in the U.S. that have been mentioned on this forum. I am trying to gather as much information as possible first, particularly trying to rule out anything that might result in failure of treatment. So far we've run ASOs and swabs on the whole family, and sent blood for Cunninghams. Any other suggestions?