Bad flare after tonsillectomy - potential cause?

[mdenglund]

Hi, All -

 

My daughter had a T&A procedure on Monday of this wk. She was great the remainder of the day after the surgery, but we saw a huge flare yesterday and into today with the OCD and emotional instability (back to what it was at the initial recognition of an issue). I have read that this is somewhat common, correct? How long did it last for many of you who saw this? We still have her on penicillin, and plan to increase to 2x day vs. 1 starting today.

 

The other 'wrinkle' which I fear might be the case is that I was diagnosed with the flu yesterday.... I looked a bit, but couldn't find a lot on it - could she have the flu and not show any 'normal' symptoms as is the case with strep and Pandas???

 

We have a clinic appointment for later this morning, but wanted all of your thoughts prior.

 

Thank you all in advance for any and all ideas/thoughts!

 

Regards,
Marty

[airial95]

The surgery can release bacteria directly into the bloodstream, especially if the tonsils are harboring infection. Many PANDAS docs insist on strong abx prior to, IV abx during, and continuing a strong course of abx for sometime after to combat any bacteria released.

 

If you have access to stronger abx, I would definitely get back on them.

[qannie47]

Did they do a steroid IV during / before surgery?

[mdenglund]

Thanks for the questions/thoughts.

 

I called the ENT doctor to see what the course of abx/steriods were (if any) during the procedure, so I can update with that information once I hear back. I also inquired on the need for stronger abx during this recovery time. Prior to the procedure, she was on augmentin and then rifampin for the last 5 days of her 10 day augmentin. During that time (specifically rifampin), she was by far at her best. Prior to that, it was just penicillin/cephalxin, but she had been on some type of abx for 2 months prior to the procedure.

 

If I can is augmentin a good, stronger abx to get her back on??

 

Thank you again - this is quite discouraging!!

[cobbiemommy]

We had 10 days of abx and all was fine. Three days after going off abx, it all went to heck... Two steroid tapers later we were better than baseline. He is taking clindamycin now for impetigo (strep on the skin) and doc just ordered ten more days of it and he is doing well while on abx. We are three months out from his T&A and he is getting fantastic grades but still struggling socially. I would definitely ask the treating physician for something that they think will help. My thoughts are with you.

[mdenglund]

Hi -

 

I spoke with the ENT's nurse and he did use both abx and steriods in IV during the procedure. He prescribed her Omnicef as an alternative to Penicillin, but am wondering if others have experience with this - good, bad, or otherwise as an alternative course of action which might help? If that is not preferred, I can call her pediatrician to see what they would recommend too.

 

Thank you again, all!

 

Marty

[airial95]

My daughter takes Cefdinir (generic omnicef) because she has a penicillin allergy - she does okay on it.