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Ok, urinary frequency better after antibiotics; now what?


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4.5yo DS has sudden onset of extrodinary frequent urination. He was visting the bathroom sometimes every minute.

 

After some research I came across PANDAS and had a throat culture done. Came back positive (rapid test).

 

So he was on antibiotics 10 days and his urination is back to normal already.

 

What should I do next? Throat culture again? When?

 

Aything else?

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I would start by studying and learning anything you can about PANDAS, b/c if you do that, chances are you will have more info than a lot of docs which you will need to figure out what's best for your son.

I would at the very least have frequent throat cultures. If the rapid EVER comes back negative, have them do a 72 hour culture. You can ask them to send it as an upper respiratory culture (same swab, they just run the test differently). If they run just a regular throat culture, they will not be looking for strep other than strep A.

Another thing you may want to start researching is the use of prophylactic antibiotics. I am really glad your son responded so quickly! Good luck!

Colleen

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Here's the benefit of my hindsight:

 

I'd get another throat culture @ week after abx whether there are symptoms or not. (maybe hard to get your doctor to do this if there are no symptoms) The reason is because its good to have a documented negative in the absence of symptoms. Then, if/when symptoms return (I'm talking PANDAS behaviors) get another throat swab (again regardless of typical symptoms). What you want is to establish a pattern of symptom exacerbations that can be linked to the strep as directly as possible. Having a negative in the absence of symptoms will help with this.

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Thanks. I think my doc will be fine doing another throat culture whenever I ask, he'll probably want to do a rapid one, but I'll insist on the 72 hour one.

 

I'll have it done in about a week and get myself done at the same time, just to see if I'm a carrier. I have a white spot in the back of my throat which weirds me out, it's tiny and I never would have known it was there if I weren't trying to familiarize myself with what a throat should look like. Can white spots ever mean somethign besides strep? It's small, but bright white. I'm 7 months pregnant so not jumping up and down to take abx or I'd go ahead and go in for a culture.

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My daughter's doc always did 2 swabs at the same time, 1 for rapid and the second in case the rapid comes up negative, to send for culture. The rapid is pretty accurate if it shows positive. You only need the culture to test for a false negative.

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I just wanted to add that someone dr's offices take 2 swabs, hold them together, swab the throat with both at the same time, then do a rapid on one and send out the other. This is NOT the best way to get a really good sample. It's best if they only swab with one at a time. Make sure they get both tonsils and not just one.

Colleen

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