Strep in the house

[ShaesMom]

Hi,

 

I took my son to the urgent care facility on Saturday because he was coughing and running a slight fever-he looked horrible. They didn't think it was the flu so they swabbed him and I just found out that the culture came back positive for strep. ARG!!! He never had a sore throat either! i on the other hand have a sore throat but I always attribute it to my Fibromyalgia.

 

So, what are your thoughts on what I should do for Shae. She is currently on 200mg of Erthyromycin twice a day. I have an RX for PENVK on file for her at the pharmacy. Is 400 mg a day a treatment dose or should I up it? Should I get the RX for PenVK filled and give her both??

 

Fortunately, she had IVIG on the 4th so hopefully her immune system is in full swing and will protect her. On the other hand, she was "off" last week so her Dad I knew something was up.

 

I'm trying not to freak out right now but this scares the daylights out of me. One-I don't want her to go backwards and two-I don't want my son to get Pandas.

 

Sam

[Kayanne]

Hi,

 

I took my son to the urgent care facility on Saturday because he was coughing and running a slight fever-he looked horrible. They didn't think it was the flu so they swabbed him and I just found out that the culture came back positive for strep. ARG!!! He never had a sore throat either! i on the other hand have a sore throat but I always attribute it to my Fibromyalgia.

 

So, what are your thoughts on what I should do for Shae. She is currently on 200mg of Erthyromycin twice a day. I have an RX for PENVK on file for her at the pharmacy. Is 400 mg a day a treatment dose or should I up it? Should I get the RX for PenVK filled and give her both??

 

Fortunately, she had IVIG on the 4th so hopefully her immune system is in full swing and will protect her. On the other hand, she was "off" last week so her Dad I knew something was up.

 

I'm trying not to freak out right now but this scares the daylights out of me. One-I don't want her to go backwards and two-I don't want my son to get Pandas.

 

Sam

 

 

Have you had your throat cultured?

 

If possible, I would take her for a rapid strep test at her doctors...250 mg twice daily is the reccommended dose for prophylaxis--that is probably for an adult. What is her weight? Is she small? My ped said that when you are on a prophlactic antibiotic the rapid strep test would still pick up if there was any strep antigens present.

 

Chances are she is being protected by the erythromycin.

 

When it comes to having an actual strep infection, penicillian and amoxicillin cannot reach intra-cellular strep or strep that has bound with other bacteria...so I wouldn't bother with the pen vk...if anything I would just increase the erythromycin.

 

What antibiotic was your son put on?

[Suzan]

Hi,

 

I took my son to the urgent care facility on Saturday because he was coughing and running a slight fever-he looked horrible. They didn't think it was the flu so they swabbed him and I just found out that the culture came back positive for strep. ARG!!! He never had a sore throat either! i on the other hand have a sore throat but I always attribute it to my Fibromyalgia.

 

So, what are your thoughts on what I should do for Shae. She is currently on 200mg of Erthyromycin twice a day. I have an RX for PENVK on file for her at the pharmacy. Is 400 mg a day a treatment dose or should I up it? Should I get the RX for PenVK filled and give her both??

 

Fortunately, she had IVIG on the 4th so hopefully her immune system is in full swing and will protect her. On the other hand, she was "off" last week so her Dad I knew something was up.

 

I'm trying not to freak out right now but this scares the daylights out of me. One-I don't want her to go backwards and two-I don't want my son to get Pandas.

 

Sam

 

Oh No! I agree that you should get swabbed too just to be sure. I don't know much about erthyromycin so I'll defer to the other parents on that one. But I sincerely hope Shae does not get strep. I am worried about you guys! I HATE that I woke you up so late after you spent the day at urgent care! What a crazy weekend.

 

I can only imagine how worried you are about Shae but also your son. I pray that he processes this strep and never gets any symptoms of PANDAS.

 

Susan

[colleenrn]

Sam

I would probably increase the erythromycin. The treatment dose is 30-50mg/kg/day, in divided doses and not to exceed 4,000 mg/day. What is Shae's weight? I would try to keep your children as separate as possible, throw out toothbrushes and even toothpaste that may have been contaminated. Have you ever used xylitol? You can get it in mouthwash, nasal spray, and gum. Maybe you could add that temporarily- nit can kill strep in the mouth and sinuses.

As far as rapid strep tests while on antibiotics- I would say it would not show a positive. I have lost all faith in the rapids b/c so many times the rapids are negative for my kids, then the culture is positive. I also think anyone else in the house should be swabbed, esp. if you have a sore throat, just to rule out that you didn't gt exposed by your son.

 

Good luck!

Colleen

[Kayanne]

Sam

I would probably increase the erythromycin. The treatment dose is 30-50mg/kg/day, in divided doses and not to exceed 4,000 mg/day. What is Shae's weight? I would try to keep your children as separate as possible, throw out toothbrushes and even toothpaste that may have been contaminated. Have you ever used xylitol? You can get it in mouthwash, nasal spray, and gum. Maybe you could add that temporarily- nit can kill strep in the mouth and sinuses.

As far as rapid strep tests while on antibiotics- I would say it would not show a positive. I have lost all faith in the rapids b/c so many times the rapids are negative for my kids, then the culture is positive. I also think anyone else in the house should be swabbed, esp. if you have a sore throat, just to rule out that you didn't gt exposed by your son.

 

Good luck!

Colleen

 

I should have clarified that I too think a follow up 72 hour culture is needed if the rapid comes back negative...especially since you know she has had exposure to strep...but it is still possible to get a positive rapid strep test if taking prophylactic antibiotics.

[thereishope]

I wanted to send you some reassurance about your son. All 3 of my kids do not get strep symptoms. Only one has PANDAS. Obviously keep a close eye on your son, but do know he may not have the same disorder as your daughter. It's the worse thing to have a silent predator (strep) that won't veen show itself in the classic way. We are always left wondering what to do w/o always going to the doctor. I freak out more because my boys share a bedroom.

[ShaesMom]

I have a doctor's appt for myself tomorrow. My GP is usually pretty good about giving me an abx if someone else in the house has strep because I also have a long history of strep infections.

 

My husband is already on Omnicef because he tested postive last week for Beta Streptococcus-Non Strep A. He didn't have any symptoms and was tested just because he has a sore in his mouth and the Doctor knew I would appreciate it. She swabbed his throat-not the sore. so, now we are pretty sure he is a carrier. I have no idea what do about that since it is non strep A and I know the doctors will say it is no big deal but Shae doesn't make antibodies to ANY of the streptococcus-that's why she is on monthly IVIG now.

 

I called Shae's Ped and she said the dose she was on is fine. I'm not inclined to believe it though.

 

Kayanne-She was in to see her Ped a couple of weeks ago when she was complaining of a sore throat and the Ped told us that because of the abx a throat culture would likely NOT be positive. She was tested-all negative.

 

I told the Doctor at the urgent care place that if my son came back positive I did not want amoxicillan or augmentin. He looked me a little shocked. He gave him Keflex.

 

Susan-I was only at Urgent Care for an hour. Call anytime you need someone to talk to!

 

Colleen-She weighs 40 pounds. So, is that enough or do I need to up it. I'm terrible at figuring out the math when it comes to rx's. I picked up new toothbrushes and toothpaste when I went to get his abx.

 

I went to pick up a copy of his positive results and I have to say I am a little peeved. It looks like they received his results yesterday afternoon. I called them today to ask about it (it was suppose to be back today). He played football yesterday and went to school today. I could have had him started on abx yesterday and got myself in to see the doctor today.

[pixiesmommy]

Oh no!! I have no advice.. it all seems so confusing and overwhelming to me. I feel, as I'm sure we all do, that I'm living on pins and needles wondering if any of us have strep and what to do when/if we do! Argh!!

 

Can I ask why you said specifically no Augmentin? That is the prophylactic abx that Dr K has Pixie on, so just curious.

 

PS- got your message, but things are nutty here and haven't been able to call. Hope we can talk again once things calm down at both our homes!

 

Hugs,

Manda

[ShaesMom]

Oh no!! I have no advice.. it all seems so confusing and overwhelming to me. I feel, as I'm sure we all do, that I'm living on pins and needles wondering if any of us have strep and what to do when/if we do! Argh!!

 

Can I ask why you said specifically no Augmentin? That is the prophylactic abx that Dr K has Pixie on, so just curious.

 

PS- got your message, but things are nutty here and haven't been able to call. Hope we can talk again once things calm down at both our homes!

 

Hugs,

Manda

 

Manda-

 

My son was on IV abx when he was two weeks old for Group B strep & bacterial meningitis. His body seems to laugh at amoxicillan and augmentin so I have learned to just ask for something stronger or I will be back at the doctor with him two weeks later.

 

I hope things are nutty in a good way and that Pixie is doing great!

 

Sam

[ShaesMom]

I wanted to send you some reassurance about your son. All 3 of my kids do not get strep symptoms. Only one has PANDAS. Obviously keep a close eye on your son, but do know he may not have the same disorder as your daughter. It's the worse thing to have a silent predator (strep) that won't veen show itself in the classic way. We are always left wondering what to do w/o always going to the doctor. I freak out more because my boys share a bedroom.

 

 

Thanks for the reassurance Vicki!

[colleenrn]

Sam,

With Shae weighing 40 lb., given that the treatment dose for strep is 30-50 mg/kg/day, the lower dose (30 mg/kg/day) would be 300mg, twice a day.

The higher dose (50mg/kg/day) would be 450mg, twice per day.

 

I am assuming that if her dose is 200mg, twice per day, that she is taking the liquid. If it were my child, and I am not in any way telling you what to do, I would increase her dose for 10 days, to a treatment dose.

 

If you are giving her 1 tsp 2x/day, she is getting 200mg, twice per day.

 

If you increase the dose to 1 1/2 tsp, 2x/day, she would be getting 300mg, 2x/day (which is the lower treatment dose of 30mg/kg/day).

 

If you increase the dose to 2 tsp, 2x/day, she would be getting 400mg, 2x/day (which is the treatment dose of 44mg/kg/day). (treatment dose range 30-50mg/kg/day)

 

I hope this helps some!

 

Colleen

[ShaesMom]

Sam,

With Shae weighing 40 lb., given that the treatment dose for strep is 30-50 mg/kg/day, the lower dose (30 mg/kg/day) would be 300mg, twice a day.

The higher dose (50mg/kg/day) would be 450mg, twice per day.

 

I am assuming that if her dose is 200mg, twice per day, that she is taking the liquid. If it were my child, and I am not in any way telling you what to do, I would increase her dose for 10 days, to a treatment dose.

 

If you are giving her 1 tsp 2x/day, she is getting 200mg, twice per day.

 

If you increase the dose to 1 1/2 tsp, 2x/day, she would be getting 300mg, 2x/day (which is the lower treatment dose of 30mg/kg/day).

 

If you increase the dose to 2 tsp, 2x/day, she would be getting 400mg, 2x/day (which is the treatment dose of 44mg/kg/day). (treatment dose range 30-50mg/kg/day)

 

I hope this helps some!

 

Colleen

 

Thanks Colleen and thanks for getting back to me regarding the Beta Strep too.