check fam for strep?

[Bio and adopt]

I want to have our whole family checked for strep, although no one is symptomatic. Do they do rapid test, cultures or blood antibody test?

My PANDAS son had strep 6 weeks ago and now is in a exacerbation. I had a script for Biaxin XL and started him on that. If I take him for retest will he be negative because of the three days of antibiotics? Should his strep titers be elevated at this point? Although I dont believe his titers get elevated which makes this harder.

[EAMom]

I would do rapid first...if that is negative then do the 72 hour culture.

 

If the 72 hour culture is negative then consider titers (not everyone gets a titer rise, even with pos. cultures), but a high titer might indicate strep even if throat cultures are negative (eg. in the sinuses or elsewhere).

 

Titers might also be helpful if the doc wasn't able to get a good swab of the child's tonsils.

Edited November 4, 2010 by EAMom

[norcalmom]

Titers don't tell you if he has an infection - just that he had an infection (which you already know correct?). You can take two sets - and see if the titers are going up or down...I forget how long they rise for for a normal course of strep throat, but you could look it up, I think 8? weeks or so? then they should start going down, if you don't still have active strep.

 

And of course, not everyone gets elevated titers...but if he cultured positive for strep 6 weeks ago...you will know for sure if his titers are "active" if you get his titers taken now (or whenever the high point is supposed to be).

 

As for the family - you could do all of it. We only did rapid and culture on family members, no titers, but do know other folks have done the titers and found a carrier that way.