Strep AGAIN - in his nose!

[airial95]

We've been doing really well. We were off abx for about 6 weeks over the holidays, and then in mid February he got strep. We caught it VERY early and had him in for a culture within 48-72 hours of seeing the very first odd behaviors. AS a result, combined with our behavior therapy, the episode wasn't as bad as it could've been, and we managed well. Our pediatrician - who is AWESOME - put us on a 90 day course of full strength Cefdinir. We still have about 8-9 days left.

 

Over the couse of the 90 days, he got a couple of little pimply things that could've been impetigo, the were accompanied by bumps in the behavior.

We added the topical abx and were back to "normal" in about 24 hours. Thigs have been going good. We felt like we were somewhat in control.

 

Last week we saw a pretty significant ramp up in behavior - mostly rage - and we had a "tantrum till we drop" which we haven't had in a while. But he had a pretty bad cold at the time, we treated the cold (didn't go to the doctor since we didn't see any of our "Slam dunk" strep behaviors) and we saw improvement in the behavior. On Monday, he had 2 potty accidents at school, and threatened another little boy to "shoot him dead" if he came near him. We've never heard him say anything like that, and he doesn't even have any toy guns he plays with. It's gotten worse every day, severe seperation anxiety during drop off at school, rages and violence with his friends at school, the OCD at mealtimes (our worst) has been so bad he hasn't eaten dinner all week.

 

This morning, ironically, I had to take him for a blood draw that Murphy's office ordered as a follow up and first step toward an immunology referral. But since things were wierd I took him into the pediatrician as well.

 

I thought - NO WAY is this strep. He's on super dose abx (his higehst dose EVER). I'm just crazy and over reacting. He started checking him out - rapid heart rate, indicative of strep. Asked if he's had nose bleeds - nope - then shows me this like pattern of "Stuff" up his nose - all I can say is that it looked like really fine boogers caught in really long nose hair (which he doesn't have) He cultured it (wasn't sure it would work since the culture isn't designed for that use but why not) - very very faint positive. Even with out the cultrue, Dr. says - that's your infection - strep - wouldn't be caught by the cefdinir because of where it is. Muciriprin up the nose 3x a day.

 

SERIOUSLY!!! I called the school, and his special ed teacher said to bring him in. We're trying to work with him to deal with school when he's at his worst and she said if he's not contaigious - we should keep his shcedule as normal as possible. I sort of agreed - but the seperation anxiety was TERRIBLE - but the school support was great.

 

Instead of going to work - I came home and just cried myself to sleep (the nap was kinda nice). It's like 3 steps forward 2 steps back with this nonsese. I can't take it much more. We're so blessed with a great support system - wonderful pediatrician, Dr. Muphy is local, the school AND day care has been supportive and fantastic. So I know I have it better than most, but it still hurts to see him suffering in his own little body. He so young, and so small, I just want to protect him and feel so helpless.

 

So moral of the story - if your culture comes back negative but all other signs point to strep - try a topical abx lightly applied inside the nostrils - the strep might be hanging out there!!!

[kimballot]

We've been doing really well. We were off abx for about 6 weeks over the holidays, and then in mid February he got strep. We caught it VERY early and had him in for a culture within 48-72 hours of seeing the very first odd behaviors. AS a result, combined with our behavior therapy, the episode wasn't as bad as it could've been, and we managed well. Our pediatrician - who is AWESOME - put us on a 90 day course of full strength Cefdinir. We still have about 8-9 days left.

 

Over the couse of the 90 days, he got a couple of little pimply things that could've been impetigo, the were accompanied by bumps in the behavior.

We added the topical abx and were back to "normal" in about 24 hours. Thigs have been going good. We felt like we were somewhat in control.

 

Last week we saw a pretty significant ramp up in behavior - mostly rage - and we had a "tantrum till we drop" which we haven't had in a while. But he had a pretty bad cold at the time, we treated the cold (didn't go to the doctor since we didn't see any of our "Slam dunk" strep behaviors) and we saw improvement in the behavior. On Monday, he had 2 potty accidents at school, and threatened another little boy to "shoot him dead" if he came near him. We've never heard him say anything like that, and he doesn't even have any toy guns he plays with. It's gotten worse every day, severe seperation anxiety during drop off at school, rages and violence with his friends at school, the OCD at mealtimes (our worst) has been so bad he hasn't eaten dinner all week.

 

This morning, ironically, I had to take him for a blood draw that Murphy's office ordered as a follow up and first step toward an immunology referral. But since things were wierd I took him into the pediatrician as well.

 

I thought - NO WAY is this strep. He's on super dose abx (his higehst dose EVER). I'm just crazy and over reacting. He started checking him out - rapid heart rate, indicative of strep. Asked if he's had nose bleeds - nope - then shows me this like pattern of "Stuff" up his nose - all I can say is that it looked like really fine boogers caught in really long nose hair (which he doesn't have) He cultured it (wasn't sure it would work since the culture isn't designed for that use but why not) - very very faint positive. Even with out the cultrue, Dr. says - that's your infection - strep - wouldn't be caught by the cefdinir because of where it is. Muciriprin up the nose 3x a day.

 

SERIOUSLY!!! I called the school, and his special ed teacher said to bring him in. We're trying to work with him to deal with school when he's at his worst and she said if he's not contaigious - we should keep his shcedule as normal as possible. I sort of agreed - but the seperation anxiety was TERRIBLE - but the school support was great.

 

Instead of going to work - I came home and just cried myself to sleep (the nap was kinda nice). It's like 3 steps forward 2 steps back with this nonsese. I can't take it much more. We're so blessed with a great support system - wonderful pediatrician, Dr. Muphy is local, the school AND day care has been supportive and fantastic. So I know I have it better than most, but it still hurts to see him suffering in his own little body. He so young, and so small, I just want to protect him and feel so helpless.

 

So moral of the story - if your culture comes back negative but all other signs point to strep - try a topical abx lightly applied inside the nostrils - the strep might be hanging out there!!!

 

WOW! This is really neat! My son has never had this done and we've never found strep in his throat but he's always had sinus and nose stuff and chronic nose bleeds... Why don't they make this a regular test??? I wonder how many of our "Throat culture negative" kids are harboring strep in their nostrils!!??

[peglem]

I feel ya! Every time we think we've got strep under control...here it comes back again, and even though I should be used to it, every time I hear she's positive for strep- its like somebody just hit me in the chest with a sledge hammer. I'm stunned every single time and I can't even keep the tears out of my eyes at the doc's office. So, believe it when I tell you that I'm very, very sorry this is happening to you guys. I hope you beat the crap out of it this time!

 

But, it is nice to hear that you've got a lot of support.

[thereishope]

First, I'm sorry about having strep again. Second, thank you for the update, very informative for me. I wouldn't have known the Omnicef couldn't reach that strep. I'm glad the dr didn't just say it was a resistent strain but explained it.Please keep us upated on how this nasal antibiotic works for him.

 

Cuirous if the topical antibiotic in the nose is your idea or if the dr suggested it for those "just in case" moments?

 

Buy some xylitol nasal spray, that may help too.

Edited May 19, 2011 by Vickie

[airial95]

WOW! This is really neat! My son has never had this done and we've never found strep in his throat but he's always had sinus and nose stuff and chronic nose bleeds... Why don't they make this a regular test??? I wonder how many of our "Throat culture negative" kids are harboring strep in their nostrils!!??

 

He said that doing a culture on the nose won't be particularly accurate, since the test wasn't designed for that, so a negative there wouldn't really mean anything. But that strep likes to hang out there too...

[airial95]

First, I'm sorry about having strep again. Second, thank you for the update, very informative for me. I wouldn't have known the Omnicef couldn't reach that strep. I'm glad the dr didn't just say it was a resistent strain but explained it.Please keep us upated on how this nasal antibiotic works for him.

 

Cuirous if the topical antibiotic in the nose is your idea or if the dr suggested it for those "just in case" moments?

 

Buy some xylitol nasal spray, that may help too.

 

It was the Dr's suggestion. And it wasn't the first time he had us do it. When we first got dx and put on abx, he had us doing that as a precaution, and had us swabbing up the whole family with it too - just in case. He told us today that we're doing everything "right", but if we see flare ups in the future, at the first sign start with the muciriprin and get aggressive with it - it can't hurt.

 

Just another trick for the arsenal!!!

[Johnsmom]

Can I use Bactroban?

 

 

 

 

We've been doing really well. We were off abx for about 6 weeks over the holidays, and then in mid February he got strep. We caught it VERY early and had him in for a culture within 48-72 hours of seeing the very first odd behaviors. AS a result, combined with our behavior therapy, the episode wasn't as bad as it could've been, and we managed well. Our pediatrician - who is AWESOME - put us on a 90 day course of full strength Cefdinir. We still have about 8-9 days left.

 

 

 

 

 

Over the couse of the 90 days, he got a couple of little pimply things that could've been impetigo, the were accompanied by bumps in the behavior.

We added the topical abx and were back to "normal" in about 24 hours. Thigs have been going good. We felt like we were somewhat in control.

 

Last week we saw a pretty significant ramp up in behavior - mostly rage - and we had a "tantrum till we drop" which we haven't had in a while. But he had a pretty bad cold at the time, we treated the cold (didn't go to the doctor since we didn't see any of our "Slam dunk" strep behaviors) and we saw improvement in the behavior. On Monday, he had 2 potty accidents at school, and threatened another little boy to "shoot him dead" if he came near him. We've never heard him say anything like that, and he doesn't even have any toy guns he plays with. It's gotten worse every day, severe seperation anxiety during drop off at school, rages and violence with his friends at school, the OCD at mealtimes (our worst) has been so bad he hasn't eaten dinner all week.

 

This morning, ironically, I had to take him for a blood draw that Murphy's office ordered as a follow up and first step toward an immunology referral. But since things were wierd I took him into the pediatrician as well.

 

I thought - NO WAY is this strep. He's on super dose abx (his higehst dose EVER). I'm just crazy and over reacting. He started checking him out - rapid heart rate, indicative of strep. Asked if he's had nose bleeds - nope - then shows me this like pattern of "Stuff" up his nose - all I can say is that it looked like really fine boogers caught in really long nose hair (which he doesn't have) He cultured it (wasn't sure it would work since the culture isn't designed for that use but why not) - very very faint positive. Even with out the cultrue, Dr. says - that's your infection - strep - wouldn't be caught by the cefdinir because of where it is. Muciriprin up the nose 3x a day.

 

SERIOUSLY!!! I called the school, and his special ed teacher said to bring him in. We're trying to work with him to deal with school when he's at his worst and she said if he's not contaigious - we should keep his shcedule as normal as possible. I sort of agreed - but the seperation anxiety was TERRIBLE - but the school support was great.

 

Instead of going to work - I came home and just cried myself to sleep (the nap was kinda nice). It's like 3 steps forward 2 steps back with this nonsese. I can't take it much more. We're so blessed with a great support system - wonderful pediatrician, Dr. Muphy is local, the school AND day care has been supportive and fantastic. So I know I have it better than most, but it still hurts to see him suffering in his own little body. He so young, and so small, I just want to protect him and feel so helpless.

 

So moral of the story - if your culture comes back negative but all other signs point to strep - try a topical abx lightly applied inside the nostrils - the strep might be hanging out there!!!

Edited May 20, 2011 by Johnsmom

[Stephanie2]

Johnsmom, yes you can use bactroban but it is not as effective as mupirocin. I went down this road with recurrent impetigo and we treated the nostrils. I ended up using a natural antibiotic ointment that worked better than all of them, I suppose b/c there was no resistence issue.

[thenmama]

xx

Edited March 26, 2013 by thenmama

[Johnsmom]

Thanks. He just cultured positive for staph. Not mrsa. I asked this question because now he has a runny nose and I know staph and Strep can live up in the nose. The staph is above the rectum area. It's very faint but I took him in anyway because he had rectal strep 4 years ago.

Thanks

[airial95]

We've also used altabax in the past, but our doc prefers muciriprin for the nose application.

 

Thenmama,

 

He did just try a rapid culture up the nose. He really is a very forward thinking and progressive doc. We are very lucky to have him. He doesn't look at me like I have two heads when I come in for a strep check because we're acting weird (and I think I've been right like 75%+ of the time too!!)

 

Dr. Troufexis (from Murphy's office) is expecting a child in the fall, and when we were at our last appointment and I told her that our pediatrician automatically wrote a 90 day rx when he tested positive for strep last time - she was amazed. She started asking all kinds of questions about him, and then asked for his detailed info since she's looking for pediatricians, and where he's located would work for her - would we give a recommendation? Uh - Heck Yeah!!

 

I couldn't help but think how amazing it would be if one of the Dr.'s from Murphy's office because a patieint of our pediatrician? I'm just imagining the brain-trust conversations going on!!!

[Tattoomom]

Thanks. He just cultured positive for staph. Not mrsa. I asked this question because now he has a runny nose and I know staph and Strep can live up in the nose. The staph is above the rectum area. It's very faint but I took him in anyway because he had rectal strep 4 years ago.

Thanks

 

 

While my daughter has tested positive for strep, she has also tested positive for staph in her throat. It's not MRSA, just staph, and the culture always gives the antibiotic recommendation to treat it. After trying to treat it once, and re-testing, ANOTHER staph was there and ANOTHER antibiotic was recommended but the Pediatrician didn't feel comfortable trying to treat it again, for fear of creating a MRSA strain. Why does she keep staph in her throat?!

[Tattoomom]

Asked if he's had nose bleeds - nope -

 

 

My daughter had a nose bleed 2 days ago. What would that mean?

[beeskneesmommy]

Thank you for this info! My son (age 4) had his tonsils out finally last Aug., and has not had detected Strep of the throat since. However, his titers actually elevated after months of daily Augmentin, and I am absolutely sure that he recently had Strep although he is now on a BID dose of Cefdinir. He was exposed to Strep by another kiddo at preschool and got sick with a fever and sore throat afterward. We were on vacation and I was unable to get him in for a rapid test for a week, and the test was neg. However, I had not seen that particular brand of behavior since he had his tonsils intact and was getting Strep every few weeks. I also hear that there may be other resevoires that harbor Strep, such as the rectal area. Is there a non invasive way to culture this area (like, me doing it at home while cleaning him up after the potty or something)? Don't mean to get too detailed in my thinking process, just desperate to find the source of this Strep! Thank you so much for the info and any thoughts you all have would be very welcome!