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Darla

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The neuro just left a message that his titers were elevated 1600. He had a strep infection confirmed 12-30-08. So they are still elevated two weeks later which is expected. I will have him tested in another couple of months so that I can get a baseline for further evaluation when I see an exaserbation of symptoms and can check for strep.

 

I'm just debating weather or not to start antibiotics or wait and see if he has strong symptoms the next time he gets sick. He has had tics come and go for a few years and recently ocd came into the pic ... although as I've said before I feel the tics are more ocd than tourettic. The only abrupt onset of anything I saw was his behavior. He had two nights of a raging temper that was way more than his usual yelling at us etc.. I am not sure if this can be explained away by the fact that he may have had a reaction to the azyth (red dye etc). I do know that behavior was definately a result of either the azyth or the strep for sure.

 

Should I start anitbiotics and see if ocd, tics improve?? Is that what is expected to happen when you issue the anti? And if so will I see it right away? What would be the shortest time frame that I might be able to see improvement?

 

OR should I wait until another time when he get sick again and really watch it all? This was the first time I've known to look and it was sort of after the fact.. so I just don't know.

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Well, its a judgement call. In order to confirm PANDAS you need to establish a pattern of symptom exacerbation (behaviors are symptoms) w/ a temporal relationship to strep infections. So you may want to hold off on the prophilactics until a pattern has been established. But, don't wait for typical strep throat symptoms to appear (sore throat, fever) to get strep testing done. Test as soon as you see an increase in behaviors, unless, of course typical strep symptoms appear before the behavioral symptoms. That's what I would do.

 

BUT, this is your child, not mine. Some people do not see behavioral symptoms until several weeks after strep infection (especially I think if you're still in early PANDAS) so by that time your child may test negative, although, in that case you could run titer checks to see if they've gone up from last time. My child's titers were never high, even with beaucoup positive swabs, but it sounds like your child is making the titers.

 

Is the doctor willing to give you prophilactic antibiotics at this point? I think there is wide variability in response times to the antibiotics- I've seen magical improvements w/ zith just 2 hours after the 1st dose. I don't want to complicate this for you, but if the strep has formed biofilm complexes, it likely has yeast w/in the biofilm as well and the reaction you saw to the zith could also have been yeast released from the biofilm. Zith is one of the few antibiotics that is known to penetrate biofilms (also Clarithromycin).

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if the strep has formed biofilm complexes wouldn't we still be dealing with a strep infection? And if so,if there is yeast within it,is that for everyone or just people who have an over growth of yeast? Meaning should I check him out for yeast?

 

he did have strep I believe in the sinus's, the rapid was neg but the 24hr was positive and he had bloodshot eyes with green gook in the corners complaining of ear pain.

 

thanks, for your input!

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if the strep has formed biofilm complexes wouldn't we still be dealing with a strep infection? And if so,if there is yeast within it,is that for everyone or just people who have an over growth of yeast? Meaning should I check him out for yeast?

 

thanks, for your input!

 

Because biofilms have a protective coating, the microrganisms w/in them are not subject to detection-only the bacteria/yeast outside of the outer sheild can be detected (including by the immune system). I believe most biofilms are multi-microbial, including bacteria, yeast and fungi. Let me see if I can find the thread where this was discussed, and I'll link it.

 

Here it is: http://www.latitudes.org/forums/index.php?...&hl=biofilm

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I acutally saw that link, I went through earlier today, I may have missed this part, but am I correct in thinking that if it did have a biofilm I would be dealing with multiple (chronic) strep infections?

 

If the reaction wasn't due to biofilm, could it have been caused by a regular old yeast problem? Or maybe he just reacted to the red dye? Hes eaten other things with red coloring in it and doesn't seem to have a severe reaction.

 

 

 

if the strep has formed biofilm complexes wouldn't we still be dealing with a strep infection? And if so,if there is yeast within it,is that for everyone or just people who have an over growth of yeast? Meaning should I check him out for yeast?

 

thanks, for your input!

 

Because biofilms have a protective coating, the microrganisms w/in them are not subject to detection-only the bacteria/yeast outside of the outer sheild can be detected (including by the immune system). I believe most biofilms are multi-microbial, including bacteria, yeast and fungi. Let me see if I can find the thread where this was discussed, and I'll link it.

 

Here it is: http://www.latitudes.org/forums/index.php?...&hl=biofilm

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I acutally saw that link, I went through earlier today, I may have missed this part, but am I correct in thinking that if it did have a biofilm I would be dealing with multiple (chronic) strep infections?

 

If the reaction wasn't due to biofilm, could it have been caused by a regular old yeast problem? Or maybe he just reacted to the red dye? Hes eaten other things with red coloring in it and doesn't seem to have a severe reaction.

Could have been regular old yeast w/o the biofilm-sure. I don't know about the dye, no experience with that. But, if you had the same experience w/ the plain white pill...I was trying to figure out why zith, in particular, and not other antibiotics could cause this reaction. Or was that somebody else- I think I'm too tired to post.

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Thank you, I appreciate your thoughts. It may have been someone else on the pill form, we haven't tried that yet....just the liquid.

 

 

 

 

I acutally saw that link, I went through earlier today, I may have missed this part, but am I correct in thinking that if it did have a biofilm I would be dealing with multiple (chronic) strep infections?

 

If the reaction wasn't due to biofilm, could it have been caused by a regular old yeast problem? Or maybe he just reacted to the red dye? Hes eaten other things with red coloring in it and doesn't seem to have a severe reaction.

Could have been regular old yeast w/o the biofilm-sure. I don't know about the dye, no experience with that. But, if you had the same experience w/ the plain white pill...I was trying to figure out why zith, in particular, and not other antibiotics could cause this reaction. Or was that somebody else- I think I'm too tired to post.

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IMO strep titers are unnecessary if you already have evidence of infection with a positive culture.

 

Our dd never got high titers. Lots of PANDAS kids don't.

 

Also, normal kids (who have had strep) can have high titers.

 

ASO, anti-dnase B are not the antibodies that are causing the immune response in PANDAS. (We test them to look for evidence of strep when the child is no longer culturing positive.) Lots of docs seem to be confused about this issue.

 

Here is some important titer information: http://www.latitudes.org/forums/index.php?...art=#entry29305

 

I hope this helps! ;)

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