Strep while on antibiotics?

[lsad765]

Hi all,

 

My daughter was diagnosed with PANS by Dr. T 3 weeks ago. She's been on Cefdnir since then, and in the last week was starting to show real improvement.

 

Until yesterday. She got sick with a fever and sore throat. No runny nose or congestion, so it doesn't seem like the flu. Is it possible that she could have strep, even though she has been on Cefdnir for 3 weeks??

 

I emailed Dr. T with this question, but I don't know if he'll have the time to respond. Should I take her for a regular strep test at her pediatrician? If she does have strep, would it show up if she is on Cefdnir? And if she does have strep, what would we do? Try another antibiotic (noting she is allergic to penicillin) ?

 

This is all still new to us, so I appreciate any input.

 

Thanks!

[airial95]

Yes - it is possible to get strep while on abx. My son has tested positive while on Azith, Cefdinir, Augmentin and an Augmentin/azith combo. It has shown up on rapid cultures.

 

Is your ped PANDAS friendly? Ours is, and while he says that it is uncommon to get strep while on abx, it's not unheard of (obviously in our case!!) If they are not, I would just go in to see what's up, and possibly not mention that she is on Cefdinir up front to minimize any nay-saying and reluctance to give a culture.

 

Good luck!!!

[lsad765]

Thank you for the info! I made an appointment for a throat culture for this afternoon. I won't mention the Cefdinir upfront like you suggest! If she is positive though, what should she go on? What did you do when your son tested positive while already on antibiotics? Thank you!!

 

 

 

 

Yes - it is possible to get strep while on abx. My son has tested positive while on Azith, Cefdinir, Augmentin and an Augmentin/azith combo. It has shown up on rapid cultures.

 

Is your ped PANDAS friendly? Ours is, and while he says that it is uncommon to get strep while on abx, it's not unheard of (obviously in our case!!) If they are not, I would just go in to see what's up, and possibly not mention that she is on Cefdinir up front to minimize any nay-saying and reluctance to give a culture.

 

Good luck!!!

[airial95]

We moved in progression through the abx as I listed- from cefdinir to augmentin. But a 72 hr culture would identify what type of strain and what abx will work best

[lsad765]

Thank you again! I just took for her for the culture and ... positive! Ped started her on Azithromycin but just for 5 days. Just checked with Dr. T who said to do the 5 days and check in on day 4 about how she's doing on it vis a vis the strep and her OCD/behavioral symptoms. Am hoping to then continue with Azithromycin or antibiotic because my daughters' OCD and behavioral symptoms were noticeably improving on the 18 days of Cefdnir.

[T_Anna]

I would recommend buying rapid strep test on Amazon. This way you can test you DD on day 4 at home. We have gotten strep twice while on 3 diff abx.

 

T.Anna

[airial95]

We have the home strep tests as well, though I don't often use them on the kids (usually just hubby and I) because our ped is awesome about testing whenever we want, and I like having the documentation. (We have no immune deficiencies - and it turns out all of the documented + throat cultures from the ped visits may actually help us get IVIG covered without the immune deficieny aspect - fingers crossed!!)

 

Our ped actually showed us the proper way to swab, and even let me practice on my son at his office so he could give us tips.

 

Keep a log of how progress is coming, and again, if you ever suspect strep even while on abx - get checked. I thought there was NO WAY my son could come up + while on such a strong combo of azith/augmentin. He started showing signs and sure enough - positive. So always follow your gut!!

[lsad765]

Thank you again so much for your responses. My daughter is bouncing back today on Azith. We'll see how it goes tomorrow going back to school (the real test). I'll look into the home strep tests though I worry I may not know how to do the swab correctly. I am thinking of finding a new pediatrician too. We have Dr. T as our neurologist/PANDAS expert, but I'm afraid our pediatrician's office is not terribly supportive. They all seem a little skeptical. Thanks again for the encouragement to take my daughter for the strep test yesterday. I had no idea she could get strep while on antibiotics -- that threw me for a loop but was a good lesson to learn. Now I will know to test her when she is feeling ill. Amazingly (to me), her PANDAS symptoms appeared out of the blue before she even had a fever. I didn't make the connection but now know that if I see a relapse/flare, I should check for strep asap.

 

Thanks again to everyone. This forum is amazing and I appreciate the time you took to respond to me!

[airial95]

Many kids don't get traditional strep symptoms - including my son - he only gets the PANDAS symptoms when he gets strep. We kept a log for about 2 years tracking symptoms daily (0= non-existent - 9= non-functional). It helped us identify some tell tale early signs of strep (wetting the bed is one for us). It's been such a consistent tell, that when we call the ped and they ask why we need to come in and we tell them it's cause he wet the bed last night - the typical response is "are you already on your way in?"

 

We found that by knowing his "tells", we can get him in quicker and head a flare off at the pass - he still flares, but the MAJOR bad is usually shorter and less intense if we act quickly. So for us - our ped has been our lifeline.

 

My daughter was dx last year - and we still haven't found her "tell" yet - fortunately with an understanding ped, he doesn't think I'm a loon for all the times I'm dragging in my 6 year old girl because she cried more than usual yesterday!!!

[lsad765]

Airial95, it so interesting that you say this. In the past, my daughter has felt sick many times but with no identifiable symptoms other than feeling rundown and unwell. She would always say that she has a "cold" though she would have no cold symptoms at all (no runny nose, etc.). She probably just saw the rest of us getting sick with colds and labeled her own feeling of being unwell as a cold (she is 6). Now, I'm looking back wondering if she could have strep any/all of those times? I wish this had occurred to me sooner, but we just put the whole PANS/PANDAS picture together 3 weeks ago (about 3 years late!).

 

I am keeping a daily log as you suggest and will continue this. My main concern now is finding an antibiotics that will help her and that she can stay on for awhile with the hope of continued improvement in her OCD/sensory/behavioral symptoms. I was a little surprised that Dr. T didn't just go ahead and give us a longer prescription for the Azith (he just gave 5 days and I am to report back to him at day 4), so I'm hoping it won't be a problem to get a longer prescription of Azith or something else. As everyone on this forum says, at this point I'm willing to do anything to help my little girl. I feel terrible for blaming her behavioral symptoms for the past 3 years on discipline, sensory stuff, anything else -- without knowing that PANS/PANDAS could explain it all!