Fever immediately after stopping antibiotics?

[Crunchfly]

My ds just stopped antibiotics after 6 weeks. He is suspected PANDAS after a sudden onset of multiple tics after a month of strep. He did 10 days of Augmentin followed by a month of amoxicillin. We decided to try a break since he is about 98% free of tics and other symptoms. He took his last dose on Saturday morning, and last night he has a bad headache, so I checked his temp and it was in the high 99s. He seemed well all day today, but was complaining off and on that his throat was "dry." He just started complaining that he felt warm, and his temp is now 100.1.

 

He can't have strep again this soon can he?

Any ideas?

[Mayzoo]

In the 40 days of abx, did he ever culture or rapid test negative for strep?

 

He may not have it again, but he may have it still.....meaning he may have never gotten rid of it yet. My daughter had it for almost 60 days of straight abx rapid testing every 10 days to see if it cleared yet. When we finally got a negative rapid, we sent one off for culture to confirm.

Edited May 28, 2013 by Mayzoo

[Crunchfly]

He did have a negative overnight culture done on the same day they drew the blood that showed his elevated ASO and ADB levels.

 

However, our stories are similar in that the month proceeding onset, he had strep and was given an antibiotic for 10 days that seemed to have cured the infection, but the second day off it he had a fever/headache/sore throat and an overnight culture revealed he still had strep. He was given another 10 days of a different antibiotic and 2 days after he finished it he started ticcing. That's when he got the most recent culture and bloodwork done and started on 6 weeks of antibiotics.

 

All of us have been cultured overnight in the past 2 months, so we don't have a carrier in the house.

 

I am keeping him home tomorrow to try and get him into the doctor.

[nicklemama]

I'm with Mayzoo. I don't think the abx has gotten rid of the infection.

[airial95]

We have gotten strep multiple times while on abx, and yes, immediately after coming off within 24-72 hours were culturing positive again (either same infection or new one).

[Crunchfly]

You guys were right.

He tested positive on a rapid test this morning. The doctor is running the overnight culture anyway...not sure what she's looking for, but I guess she has a reason.

Ds is back on Augmentin for another 2 weeks. I plan on having him cultured at the end of the 2 weeks to know if he's clear or not.

 

What usually resolves chronic strep like this?

Do we just cycle through different antibiotics until we clear it? I know Augmentin may not have been the strongest choice, but dr and I both agreed that it was quick to clear the PANDAS symptoms that we're hoping to prevent this time around.

Do we need to start talking about getting rid of the tonsils?

[LindaMW]

This was just posted on the Pandas Network website.

 

http://pandasnetwork.org/2013/05/periodic-fevers/

[airial95]

She may be running the overnight culture to get information on what strain it is. They can sometimes tell if it's a certain strain, what type of antibiotic it will respond best to.

 

For us, we had strep every 6 weeks or so (even on full strength abx) for over 18 months, until T&A surgery, and then it was every 10 weeks or so. The last time he tested positive was in September - while he was on 500 mg Augmentin 2x day and 250 mg Azith 1x day (he was 4 and about 35 lbs at the time). We added Rifampin for 30 days - which worked well, but when the Rifampin ran out, he reported that the OCD was coming back, so the ped just renewed it. He did 60 days of that triple combo, then we tried 30 days of Cipro (which he backslid a bit, but no + cultures), and went back on the triple combo for 90 days. He had IVIG about 6 weeks ago, and finished the 90 days of Rifampin about 10 days ago (still on the Augmentin/Azith combo). Since starting the triple combo - he has not tested + for strep.

 

We have seen a backslide over the last couple of days (was at 100% pretty much after IVIG), not sure if it's discontinuing the rifampin or the fact that he has 2 loose teeth. We're working with the loose teeth theory b/c episodes are not consistent.

 

Not sure this will help - but since chronic strep has really been our nightmare, thought I would share.