ASO high, culture negative

[kos_mom]

DD had ASO done on 7/18--656. Anti DNaseB 147 (normal <120).

 

Had 103 fever 7/25 with respiratory distress. ER gave her IV Avelox for possible pneumonia and seven days oral Avelox scrip at 400 mg. Also 40 mg steroids for five days with taper finished 8/7.

 

Just learned strep culture done 8/1 came back negative. Could tx with Avelox (which I understand is not particularly effective abx for strep) been enough for culture to go negative? If not, what does negative culture with high titers mean?

 

Much thanks--want to be informed before neuro visit.

[peglem]

High titers are not necessarily a reflection of current infection status as they are known to rise several weeks after an infection. They are actually antibodies against toxins that are excreted by strep (bacterial "poop").

 

I don't know anything about avelox, but my daughter has a history of positive rapids but negative cultures while on zith. What I finally think was happening there was that the rapid was detecting strep antigen, so strep was most likely there, but since zith is taken up into the tissues, it prevented strep growth in the culture.

 

So, what do your results mean? Possibly a present strep infection, possibly only a past one. The recent illness could have been caused by an entirely different pathogen...nobody knows.

[kos_mom]

Thanks. I do wish I'd known about the possibility of a positive rapid and negative culture as we just did the culture. Too late now! In any case, the Pandas friendly ENT gave her a scrip for 30 days of clindamycin.

[colleenrn]

Strep could be elsewhere in the body. It could also be they just did not get a good swab. With an ASO of 656 I would definitely treat for strep, so the clindamycin will be good.

 

Colleen