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Found our culprit: dh has strep!

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I am glad you found the source! But not a fun situation to deal with. Are both kids currently on abx--prophylactic or treatment dose? If not on abx I would get them on and if on prophylactic dose I would bump up to treatment dose for a time. When my ds has a known exposure we go up to treatment dose for the abx he takes (azith) for one cycle, so we do 5 days with the first day being the loading dose. That has worked well for him. You could also think about checking titers. Our dr. has suggested doing that during times of flares and it has proved enlightening for us.

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I hate to say this, but keep an eye on the grandparents as well if there is a lot of contact. We've been monitoring my mother's ASO/DNASE and when ever my daughter has had a rise in titers, so has my mother. My mother's titers are always elevated, but when they significantly increase, my daughter usually has a rise (though this is her first time out of range) or a positive streptozyme screen. Right now my mother's dnase is in the high 400's - my daughter's in the high 600's. My mother was just placed on 20 days of Augmentin.

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By symptoms, I meant PANDAS symptoms. Some may find that ramping from exposure isn't as bad as being infected themself. So, if their PANDAs symptoms worsen or explode, you could retest them again as they may then test + or change/increase abx. Keep in mind you can get a false negative strep test while on abx.


Thanks for all the advice! Philamom-- appreciate the mention of grandparents, since we have two sets nearby, one that the kids spend a lot of time with. I will keep a close eye on that and I know they'd be willing to get tested or do anything we need them to in order to help the kids.


Both kids are on abx-- at what I believe is considered the treatment dose??? I'm sure it must be for ds, b/c he's in the very early stages of treatment--dx'd PANDAS in August. He had the recurrent strep, it returned on Augmentin, and he was switched back to the Clindamycin (think it's 300-- and 3x/day), which he's on now. Dd, post-IVIG (beginning of June) is on Augmentin-- 500 2x/day.


Vickie, by symptoms I assume you mean physical strep symptoms or do you mean if their PANDAS ramps up more than it already has? Did you mean to re-test b/c of the delay in getting a + swab only if they show physical signs of strep infection, or if their PANDAS symptoms increase, as well? Guess I was wondering if in your experience exposure to someone else's strep causes a certain level of activation, but plateaus, and further spiking from there would be unlikely unless they picked up the actual infection?


So, here's my naivete kicking in... what would titers tell us at this point? Neither kid had elevated titers when dx'd. But, dd's exacerbation started last fall, her bloodwork was not drawn til late winter/early spring when we were preparing to have her evaluated for PANDAS. And, she's had this for so long and it may not have been strep that set her off this fall; she'd had a flu vax and got a URI w/in a day of it-- and exploded.


Ds had his titers drawn before we went on vacation this summer, they were not elevated then (but he'd been exacerbating this spring). We came home from vacation this summer and went to his PANDAS eval with active peri-anal strep and his PANDAS symptoms significantly flaring up. But I've read the anal/skin strep doesn't elevate titers. And he's also had undiagnosed PANDAS for years now.


Also, would being on abx now effect titers?


Wondering if they have titers rise in response to exposure if that info is good for dx, treatment, both? Or to monitor their treatment effectiveness? If the info would be useful to us I could try to get the labs ordered by a ped here (though not sure they'll want to order bloodwork based on just my asking for it, esp with negative cultures and knowing we see a specialist for this). Fortunately our PANDAS doc was able to get both kids on the schedule for next Wed afternoon. Is there a timeframe I should have them drawn to check titers and would that still fall within it? Unless there's a reason not to wait I think I'll put it on my list of questions for our PANDAS doc appointment.


I am going to call my doc today and get on abx myself right away, too. They offered it and I want to be sure we get everyone cleared so we don't continue the exposure or keep passing it back and forth.


Thanks again for all of the advice and support!



Edited by Vickie
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