Worse before better?

[browneyesmom]

My daughter was diagnosed on Wednesday morning with her 3rd (possibly 4th) strep throat infection in a row. Our pediatrician opted to treat her with Augmentin and Azithromycin this time.

 

That afternoon/evening, she had an episode of urinary incontinence (we've seen some of this and nocturnal enuresis over the last several months occasionally), then had nocturnal enuresis last night soon after going to sleep. The separation anxiety, worry and defiance issues seem to be climbing a bit this week and today, she had an outburst where she called me a freak, etc... it was similar to others she's had the first 6 weeks of this year before she was on Amoxicillin and got somewhat better... before she got sick again.

 

She has had a fever running around 100, even on Ibuprofen as well as diarrhea since Tuesday, so I don't know if that is factoring into this in some way. I don't know what to think about much at this point.

 

My question is... is it typical for kids to get a little worse in the beginning of treatment, before getting better?

 

On the Amoxicillin, I don't think we saw an improvement until she had been on it for a good week or so. Prior to that, she was on Omnicef and we saw a change for about the first 2-3 days on that, but that was it. In December, she was on Amoxicillin, but that was before the extreme changes at the beginning of 2009.

 

Our pediatrician is out of the office today, but will be back on Monday. I know that he is trying to reach Dr. K for a consult. He is not yet aware of these issues that have occured since we saw him Weds morning, but I can fax him. I am trying to wait until this afternoon, when I hope to have some information from her math teacher about her grades over that time period at the beginning of 2009 through now.

 

Thanks in advance for any insight you might be able to offer.

[chrisw]

I have seen this with my son also. I think it takes the abx. time to "catch up" to the strep. Typically, my son has had 2-3 days of continued and increasing PANDAS behaviors before they begin to level off and then decrease. We are actually doing just that right now. He started Azith. on Mon. night and had pretty bad days on Tues and Weds. but it began to improve yesterday and today. I know it's hard, but try to be patient. Hopefully you will see some improvement soon. I know how you feel.

Christie

[EAMom]

I wonder if your dd has actually has 1 ongoing strep infection (vs. 3-4) that improves while on antibiotics, but then relapses once the antibiotics are stopped.

 

Re the 100 degree fever...one explanation is that she is having a PITAND like response. Perhaps the fever/diarrhea is from a virus. I'm sure it doesn't help matters that she is also positive for strep on top of that.

 

That said, our dd took 5-10 days to improve on Azithromycin. Some kids seem to bounce back faster than others. I don't know if it is that repeat episodes take longer to respond, or what it is. It may just take time for the inflammation to get under control, and the circulating anti-brain antibodies to dissipate.

[dut]

During our dd's 1st episode, she was put on amox and it took 10 days to take effect. For those 10 days she actually got progressively worse and on day 11 we saw the turnaround. Upset tummy could be the abx maybe? the fever could still be strep maybe? as the abx don't kill it outright just keep it from reproducing, allowing the immune system to attempt to eradicate it.

 

I agree with EAMom that the 3-4 strep episodes could well be the original that was never properly got rid of... it can hang out in all sorts of places.....