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Carriers in household - now what?


laure
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While we are still waiting for Igenex results for dd9 (they are in doc's office, just haven't been read yet), dh blood work comes back: 267 ASO and 320 Anti B dNase titers, but 5.0 myco is the one that really caught my attention. (less than .9 is normal?!) Dr. put him on augmentin for 15 days. What the heck does a mycoplasma of 5.0 mean and could this be affecting PANDAS dd9? She has made progress on 500mg zith a day, but OCD contamination fears not improving and she has been on steady abx and 2 prednisone tapers since late Sept.

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I assume it is IgG for Mycoplasma? Mycoplasma pneumoniae, the bacterium that causes the softer pneumonia, is about as ubiquitous in the environment as Strep., so most of us have come in contact with it, and hence, have antibodies against it. A highly elevated IgG suggests a fairly recent exposure/infection, while lower elevated values suggest some exposure in the past. Since IgG antibodies persist in the body for a LONG time, there really is no way of knowing when exposure/infection occurred. If there were IgM antibodies, this indicates a very recent or present infection. Nearly all of us have antibodies against Mycoplasma since it is so common. There are physicians out there who believe highly elevated IgG should be treated just in case... since there are case reports of both children and adults presenting with sudden onset psychoses, OCD, and tics associated with Mycoplasma infection. In most case reports, it was reported that there was documented IgM antibody for Mycoplasma, not only IgG. In my son's case, he had highly elevated (6.7) IgG against Mycoplasma, and so doc treated with clarithromycin (Biaxin) in case this was chronic, uncleared infection. He immediately responded (he had behaviors, not tics at that time) with improved mood, concentration, and some ocd.

 

So... if it IS Mycoplasma your child should be on a -mycin class of antibiotic (clarithromycin, azithromycin,...) rather than penicillin.

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Thanks Phamid - that was very informative! DS just got tested for myco p.. We don't know results yet, but won't be changing our antibiotics (currently azith) to anything until we rule out myco p and lyme...

 

 

Do you know how this might be related to the Strep pnemoniae titers - serotype 14 (or sero-type 8)...which my DS failed all but one of?

 

 

Is mycoplasma - "walking" pnemonia, and strep pnemoniae "real" pnemonia? Are they different bacterias entirely?

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While we are still waiting for Igenex results for dd9 (they are in doc's office, just haven't been read yet), dh blood work comes back: 267 ASO and 320 Anti B dNase titers, but 5.0 myco is the one that really caught my attention. (less than .9 is normal?!) Dr. put him on augmentin for 15 days. What the heck does a mycoplasma of 5.0 mean and could this be affecting PANDAS dd9? She has made progress on 500mg zith a day, but OCD contamination fears not improving and she has been on steady abx and 2 prednisone tapers since late Sept.

 

 

Augmentin does not cover mycoplasma pneumonia. zithromax or biaxin do. mycoplasma has no cell wall. There are others that adults can use but children cannot, but I cannot find my reference to it now.

 

It is my belief that IGG and IGM for mycoplasma really vary, just like strep titers. We had low IGG and just "positive" IGM (current infection)and then negative IGM and only slightly higher IGG. If it were me, I would DEFINITELY treat with at least a z pack if he can get it, if not 10 or 20 days of zithromax. My children react to mycoplasma just like strep, and I am thinking maybe even worse for the mycoplasma.

 

I believe he could stay on both the augmentin (for strep) and the zith at the same time. My children have been on both for the same reasons.

 

You could also consider trying to treat your dd for both strep and myco p with the same drugs because of exposure at home, adding augmentin for at least 14 days I would say.

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While we are still waiting for Igenex results for dd9 (they are in doc's office, just haven't been read yet), dh blood work comes back: 267 ASO and 320 Anti B dNase titers, but 5.0 myco is the one that really caught my attention. (less than .9 is normal?!) Dr. put him on augmentin for 15 days. What the heck does a mycoplasma of 5.0 mean and could this be affecting PANDAS dd9? She has made progress on 500mg zith a day, but OCD contamination fears not improving and she has been on steady abx and 2 prednisone tapers since late Sept.

 

 

Augmentin does not cover mycoplasma pneumonia. zithromax or biaxin do. mycoplasma has no cell wall. There are others that adults can use but children cannot, but I cannot find my reference to it now.

 

It is my belief that IGG and IGM for mycoplasma really vary, just like strep titers. We had low IGG and just "positive" IGM (current infection)and then negative IGM and only slightly higher IGG. If it were me, I would DEFINITELY treat with at least a z pack if he can get it, if not 10 or 20 days of zithromax. My children react to mycoplasma just like strep, and I am thinking maybe even worse for the mycoplasma.

 

I believe he could stay on both the augmentin (for strep) and the zith at the same time. My children have been on both for the same reasons.

 

You could also consider trying to treat your dd for both strep and myco p with the same drugs because of exposure at home, adding augmentin for at least 14 days I would say.

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Thanks for all the replies...I am digesting all of this as best I can. Momlove you suggest treating my dd by adding augmentin - why is that? Isn't she covered by the azithromax for both strep and myco? Interestingly the last time we added Augmentin she went CRAZY, literally was hopping around the house on one foot like Saving Sammy, and after only 8 hours and 2 pills. I know that could mean toxins are being released, though, which is why Dr. B took her off it for now and ordered the Igenex test. And am I correct in reading that your kids react to myco even when someone else in the house has it?

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Laure,

 

I only suggested augmentin because it does seem to be a first choice for strep among doctors. I too thought my dd 8 would be covered for strep while on zithro, but she had an exacerbation while on zith and our doctor suggested adding augmentin for 3 weeks to cover for strep, and stay on the zithro because she is fighting myco p. She had her tonsils out while on the augmentin, and now 3 weeks later, she is better, praise God that doesn't change. I'm not sure if it is the T&A or the augmentin or both. There were alot of strep notes home from school.

 

I'm sorry, I didn't know your history with augmentin. Certainly, maybe Dr. B will suggest something else or just stick with the zith. I thought your dh's strep titers were a little high, certainly the dnase b and maybe your dd was exposed. I would ask Dr. B about it. I am interested in the conversation on here about omnicef. I wonder if that could do the trick for us. Amoxicillan has failed for my dd for strep in the past but augmentin is a stronger medicine than amox, although still a penicillan.

 

Good luck. I'm still muddling through myself. I hope your dh can get treated for that myco p.

Edited by mom love
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After close to 6 years of struggle with PITAND clearly caused by MycopP and a very reluctant medical establishment but for one small and very brave lady GP, we ended up with treating our now 20 years old Sandra with Azith 500 mg/daily starting of January 2010. We noticed her PITAND symptoms as Mycoplasma Pnaomonia sy,ptoms started not long after she had Influenza. Throughout the years we had good (some very good and rather long lasting) but not permanent results with abx, Prednisone and IVIG. Throughout the years Marjaana (the GP) and I noticed that DD's MycopP IgG kept going up while reacting and going down (but insufficiently) each time she was treated with immunimodulatory treastment and her leucocyte level was elevated (over the top limit, but not dramatically enough to make any other MD interested) and reacted by going down with each treatment. Last Januyary IgG was ca 200 (normal is 35) and she was totally bed-ridden with both "grand" OCD and chorea-athetosis symptoms. We see clear and undoubted improvement. Sandra's IgG kept going down the longer she was taking the Azith, and 6 monhts after starting the on-going Azith it was 39! Her symptoms too keep on getting better. True, this is a millimeter at the time kind of process, sometimes regressing real scarily but the total sum is always that of going forward. She is now out of bed, this October she started going the later part of the day unaided (it takes her some hours to start going, but she DOES). Her fogginess (ability to focus) is highly improved (the best indication of which is the quality of her piano playing and ability to read), she even started watching some TV (could not watch any moving picture and blinking light)!

As she never tested positive to Strep by any of the tests available here and we clkearly know when she had Mycoplasma Pneomonia and when PITAND started and what treatment it reacted to, our humble conclusion is that Mycop.P IgG is highly significant, indicates the existance of the bacteria active somewhere in a body and PITAND symptoms point at its activity, and must be treated.

I got IVIG way back in 2007. It was effective but did not last (see special reasons in my previous messages). Up to the beginning of 2010 we did not have any lengthy ABX, and once we started this long rise we are going through at the moment we asked for but were strictly denied any IVIG. I would like to add tht I am talking here about Finland and the public system (her special insurance refused in 2007 and expired when she turned 20). I strongly believe that there is no one other physician in Finland really interested in PITAND or PANDAS but for our GP Marjaana, who is out of the public system and wish she could but is not in the position to prescribe or perform IVIG.

We want to believe that Sammy's story, which is our inspiration for treatment, as we know it is true and that Sandra too can achieve similar results to his. It is sad that we never did and will probably not be able to do a combination of long term Azish and IVIG, as it seems logical this might have been a possible way of expediating results, at least in Sandra's case.

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