Strep B - more confused than ever!

[familyof4]

My son, now almost 6, has had 3 distinct episodes. The first in November 07 when he developed a facial blink, anxiety and tantrums. At the time the neurologist diagnosed a tic disorder and told us the tic was not going to go away. A month later he was pretty much back to himself and we rarely saw the tic.

 

In June 08 I had strep. A week later he exploded with tics, extreme urinary frequency, anxiety, ocd, etc. His strep culture was negative and the pediatrician just wanted to wait and see. Things calmed back down within a few weeks with no intervention

 

Within the last 3 weeks the ocd and anxiety have returned. I kept waiting to see if things would get worse before I took him to the doctor. His teacher called last week to say he was not himself and almost manic in his behavior - couldn't sit still and very chatty - had to make a comment or tell a story after everything he said. I took him in to see his pediatrician and she was convinced it was PANDAS. Strep has been rampant in his school with the last cofirmed case in his class a week prior to me taking him into the doctors.

 

His rapid was neg. but she drew blood for titers and still put him on a strong dose of Zithromax (he is allergic to cephlasporins). The DNAse is not back yet but his other tests hardly registered because they were so low. He has never has strep throat that we know of. His culture grew out Strep B which the pediatrician said they normally won't even treat.

 

We have seen a dramatic improvement with the Zithromax. Strep B wouldn't cause PANDAS symptoms would it? He has had clear MRI's and CT scans of his head within the last year for other health issues and no one believes he is having any seizure activity.

 

I still think with the changes made by the Zithromax that we have to be on the right course with a PANDAS diagnosis. I just wish the bloodwork would have supported it.

[EAMom]

Read Buster's Aug. 24 and Jan. 11 posts on titers http://www.latitudes.org/forums/index.php?...art=#entry29305

 

Low titers do not rule out PANDAS. My dd had full-blown PANDAS with positive cultures...her titers (both ASO and anti-dnase b ) were low both times they were checked.

 

Perhaps the strep B is causing a PITAND response? It's also possible to have group A strep hiding out elsewhere in the body (sinuses, skin etc.) that a throat culture won't pick up on. Some strains of strep A are anaerobic (grow without air) and are difficult to culture. He could also be responding to strep in the environment without having a full-blown infection himself.

 

His symptoms/episodes and response to Azith. certainly seem consistant with a PANDAS diagnosis. The fact that he reacted when you had strep (in June) is significant IMO. PANDAS kids can react to strep in the environment even if they do not culture positive.

[colleenrn]

Strep B most definitely caused symptoms in my child. My 3 oldest children (6,8,12) had an increse in PANDAS symptoms (tics, very labile behavior) and at the same time, my 2 yo had what looked like a scarlet fever type rash on his abdomen, he was acting very wild, screaming, throwing fits, and was having short spells of apnea during his sleep. I had them all cultured, as well as myself. The three oldest cultured negative for sterp, but responded very successfully to Zithromax. My two year old cultured positive for strep B which, to this day, has me very puzzled. I cultured positive for Beta strep, BUT NOT A, B, C or G. We all went on Zithromax with good results. In trying to figure this all out and researching like crazy, I have two theories:

1. Group A strep can be misinterpreted as Group B ( I read this on different laboratory sites- it can also depend on the level of experience of the technician reading your results) OR 2. Group B can cause PANDAD symptoms. In my children, when they culture negative for strep, BUT have PANDAS symptoms AND respond to antibiotics, I believe it is twhatever bacteria they have that is causing symptoms and not just strep A. I was group B strep (GBS) positive in all four pregnancies, despite two rounds of antibiotics each pregnancy, so I wonder if I am a carrier of Group B strep and passed it to my 2 year old. I think the positive response toZithromax tells you that whatever strep it is/was, it caused PANDAS symptoms. In the beginning, when PANDAS was discovered, they believed it to be just strep A, but I thin ka lot of parents have seen other bacteria/viruses cause symptoms.

Colleen

[colleenrn]

This is the thread I started back in October when we got the "weird" step results. Thought I would post it for you just in case it helps.

Colleen

http://www.latitudes.org/forums/index.php?...ic=4107&hl=