eljomom Posted January 12, 2011 Report Share Posted January 12, 2011 Posted last night about dd's throat itching past couple days. today 100 fever. i would NEVER normally even think about bringing a kid in for this, but....that has bitten me. So, she's been on zith. for a month at 100 mg/day (weighs 46 pounds). Could she still have strep? One tonsil looks more swollen, and the very back of her throat has red "veins" that are really red. We have never had diagnosed strep (could have been missed over the years due to me NOT taking kids in for stuff like this!!!). Also, can you get STAPH in your throat?? Link to comment Share on other sites More sharing options...
peglem Posted January 12, 2011 Report Share Posted January 12, 2011 Posted last night about dd's throat itching past couple days. today 100 fever. i would NEVER normally even think about bringing a kid in for this, but....that has bitten me. So, she's been on zith. for a month at 100 mg/day (weighs 46 pounds). Could she still have strep? One tonsil looks more swollen, and the very back of her throat has red "veins" that are really red. We have never had diagnosed strep (could have been missed over the years due to me NOT taking kids in for stuff like this!!!). Also, can you get STAPH in your throat?? I don't know about the STAPH, but 100mg/day of zith seems low to me. The problem is also, that the zith may cause a false neg. on a culture. But, yes, my child has gotten strep while on lower, "prophylactic" doses of abx. Link to comment Share on other sites More sharing options...
Phasmid Posted January 12, 2011 Report Share Posted January 12, 2011 The itching symptom is more common with viral infections. Also a fever of 100 is not really a "fever" . If it stays low, and the throat isn't raw, swollen, and PAINFUL, it is probably not Strep or Staphylococcus, but viral. If fever climbs and throat is swollen, I would, if I were you, take her in. Link to comment Share on other sites More sharing options...
SarahJane Posted January 12, 2011 Report Share Posted January 12, 2011 I had an urgent treatment PA give me abx after a neg strep swab because she told me that it ONLY tests for Strep A & it could be some other strep or staph. I agree the 100mg of zith seems low. My son is 46lbs and is on 250mg of zith (pill) daily post IVIG. I think a regular dose of liquid zith is 200mg. May not have had a high enough dose to get rid of the bug. Some strains of strep can be resistant to certain abx too. (She was also on Augmentin too, right? but was it a high enough dose if this dose is too low?). Ear infections are also common after strep...so if you've had a neg (or false neg) on a strep test, perhaps get the ears checked. I'd lean on taking her to get more meds even if she's asymptomatic. You can always request a titers test with higher dose abx while waiting for the results. Link to comment Share on other sites More sharing options...
EAMom Posted January 12, 2011 Report Share Posted January 12, 2011 Yes, I was thinking the same thing...that it might be viral. Strep is unlikely to have a runny nose or cough...so if either of those develop it's less likely to be strep throat. But, 100mg/day isn't a high dose of Azith. and there are some Azith. resistant strains of strep. Link to comment Share on other sites More sharing options...
eljomom Posted January 12, 2011 Author Report Share Posted January 12, 2011 Initially I thought it might be an allergic reaction to the zithromax. I know they can develop any time...even if a child has taken that abx previously just fine, and even mid-treatment (happened to 3 of my 4 kids). But now her fever is over 101. I swear, I am so out of my element here, as I have let fevers of 104 "run their course"--makes me sick to even say that now. I looked in her throat again, and there are some dark-reddish little patches on the roof of her mouth....really just don't even know what to do. I switched ped's when we first started this, because for 3 months my regular ped. poo-poo'd pandas. But new ped. it 50 minutes away, and is not even in the office today. I can't even imagine going to a doc and not only having to bring them up to speed with pandas, but to explain why my kid has been on abx so long without diagnosed strep anywhere....sigh. Link to comment Share on other sites More sharing options...
peglem Posted January 12, 2011 Report Share Posted January 12, 2011 Initially I thought it might be an allergic reaction to the zithromax. I know they can develop any time...even if a child has taken that abx previously just fine, and even mid-treatment (happened to 3 of my 4 kids). But now her fever is over 101. I swear, I am so out of my element here, as I have let fevers of 104 "run their course"--makes me sick to even say that now. I looked in her throat again, and there are some dark-reddish little patches on the roof of her mouth....really just don't even know what to do. I switched ped's when we first started this, because for 3 months my regular ped. poo-poo'd pandas. But new ped. it 50 minutes away, and is not even in the office today. I can't even imagine going to a doc and not only having to bring them up to speed with pandas, but to explain why my kid has been on abx so long without diagnosed strep anywhere....sigh. Go to urgent care, explain that your child has an infection triggered autoimmune condition and you'd like a strep test. I find that UC will often rx abx before the culture comes back and tell you to discontinue if it comes back neg. Link to comment Share on other sites More sharing options...
Stephanie2 Posted January 12, 2011 Report Share Posted January 12, 2011 my 6yo had staph on one of his throat cultures. think i told you that in the other thread. but my 2 cents on the azith is maybe you need an abx switch to see what happens. then again, if you are not seeing the pandas symptoms ramp up then maybe wait it out...? Link to comment Share on other sites More sharing options...
matis_mom Posted January 12, 2011 Report Share Posted January 12, 2011 Initially I thought it might be an allergic reaction to the zithromax. I know they can develop any time...even if a child has taken that abx previously just fine, and even mid-treatment (happened to 3 of my 4 kids). But now her fever is over 101. I swear, I am so out of my element here, as I have let fevers of 104 "run their course"--makes me sick to even say that now. I looked in her throat again, and there are some dark-reddish little patches on the roof of her mouth....really just don't even know what to do. I switched ped's when we first started this, because for 3 months my regular ped. poo-poo'd pandas. But new ped. it 50 minutes away, and is not even in the office today. I can't even imagine going to a doc and not only having to bring them up to speed with pandas, but to explain why my kid has been on abx so long without diagnosed strep anywhere....sigh. Oh, I'm so there with you having let things run their course! Not any more... I would take her in just for peace of mind. They CAN get strep (or other stuff) while on abxs. My PANDAS son got an ear infection while on Augmentin XR (2000mg/day). Incidently, his sister had an ear infection too at the same time, and now she is being treated for PANDAS/Lyme as well, and some of the others had strep. PANDAS ds was showing an increase in symptoms, so I knew something was up. But I have to say a few weeks ago two of my girls had the itchy/bothering me throat, and I saw those red dots on the roofs of their mouths, along with swollen tonsils. I googled it and I panicked (sp?) as it turned up as a sign of strep. But one of my dauthers was already on abx, and I wasn't seeing a "mental" reaction. So I waited it out and it passed. They did NOT have a fever, though. How is she doing with her PANDAS symptoms? That would be what I would look at first. If you do take her in, see if they can do a culture with sensitivities. I have yet to have this done on my kids, but I did insist on them doing it when they took my tonsils out, and it turns out there was a different bug there (pseudomonas) besides strep, which is resistant to all the antibiotics they had tried on me (Augmentin, Biaxin, Cefuroxime). So maybe if they could do that it would be helpful because you can find out which antibiotics would work/not work for her. Link to comment Share on other sites More sharing options...
eljomom Posted January 13, 2011 Author Report Share Posted January 13, 2011 What's a culture with sensitivities?? As for her behavior, I don't want to get too ahead of myself, but she is about as happy as I've seen her---still ticcing away, etc., but quite "hyper" in a good way. Almost manic happy, being sick and all. Weird. I'll take that over freaking out any day though. Link to comment Share on other sites More sharing options...
browneyesmom Posted January 13, 2011 Report Share Posted January 13, 2011 Yes, they can get strep (or fail to eradicate it) while on antibiotics. Strep does not always come with a fever. Some kids do not have fever at all with strep throat infection. My DD11 happens to be one of those (high fevers with ear infections though) but there are lots of kids that present this way, given what I've read and the kids I've sent home to the doc from the school clinic who turned out to be positive for strep, with no fever. I too, would take her in for peace of mind, given her history - just explain her condition as in the case of our children with this, history has taught us it is better to be proactive. Trust your instincts. I hope she's feeling better soon and you both rest well tonight. Link to comment Share on other sites More sharing options...
peglem Posted January 13, 2011 Report Share Posted January 13, 2011 What's a culture with sensitivities?? As for her behavior, I don't want to get too ahead of myself, but she is about as happy as I've seen her---still ticcing away, etc., but quite "hyper" in a good way. Almost manic happy, being sick and all. Weird. I'll take that over freaking out any day though. When my child had a fever (very rare), it was like a vacation from PANDAS, but as soon as it was gone- LOOK OUT! Link to comment Share on other sites More sharing options...
eljomom Posted January 13, 2011 Author Report Share Posted January 13, 2011 Peglem---huh??? oh crud....can you explain what you mean?? why do you get a break during a fever?? What's a culture with sensitivities?? As for her behavior, I don't want to get too ahead of myself, but she is about as happy as I've seen her---still ticcing away, etc., but quite "hyper" in a good way. Almost manic happy, being sick and all. Weird. I'll take that over freaking out any day though. When my child had a fever (very rare), it was like a vacation from PANDAS, but as soon as it was gone- LOOK OUT! Link to comment Share on other sites More sharing options...
peglem Posted January 13, 2011 Report Share Posted January 13, 2011 Peglem---huh??? oh crud....can you explain what you mean?? why do you get a break during a fever?? What's a culture with sensitivities?? As for her behavior, I don't want to get too ahead of myself, but she is about as happy as I've seen her---still ticcing away, etc., but quite "hyper" in a good way. Almost manic happy, being sick and all. Weird. I'll take that over freaking out any day though. When my child had a fever (very rare), it was like a vacation from PANDAS, but as soon as it was gone- LOOK OUT! Well, first of all, she's immune deficient, so we had maybe 3 or 4 fevers her whole life- she was just not very symptomatic for any infections she had. But, when she did manage to produce a fever, a calm came over her, she was actually lethargic (very unusual, she's a hyper, hyper kid)no aggression, no fight or flight episodes, just laying around! But once the fever cleared, we'd end up with serious PANDAS episode. Link to comment Share on other sites More sharing options...
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