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My 7.5 yo son was doing so well since mid-September that I really thought his tics might be so low-level as to not be an issue any more. But now they are back worse than I've seen in a long time. I could really use some advice.


Many tests have come back negative, although he had a high DNASE and ASO at his very worst almost 12 months ago. A titre done in the summer showed them gradually declining. He is due for another titer in early Feb.


He had croup, with a fever and bad cough, about 10 days ago. About 5 days ago the tics started coming back. He also was at the doc yesterday for a rash that rings his mouth. I thought maybe strep-based impetigo, but she thought it was lip-licking dermititis and prescribed topical mupirocin (bactroban).


She also did a 48 hour throat culture, should get the results tomorrow.


I can make a clinic appt for Saturday (tomorrow). But...what do I ask for? Propylactic antibiotics on the thought that this is PANDAS?


This is really upsetting, as I have noticed very very few tics in months (although my husband says he's seen some).


Can anyone help?


-- Liane

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I would suggest getting his ASO and anti DNASE tested again just to see. Although, with my PANDAS son, the initial starting of it was strep, but after that any illness set him off so I wouldn't rule out PANDAS even if strep is negative. I think the PANDAS situation is worth at least checking into. Fevers especially cause problems with my son.

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The 48 hour culture came back negative -- it usually does, even though the titers are always higher than normal range.


I have an appointment for Mon evening. Based on a comment the doctor said, I'm wondering if his adenoids are enlarged. He has all the classic symptoms -- chronic mouth breather, restless sleeper, snoring, keeping mouth open most of the time, etc.


Could they harbor strep?

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