Positive Rapid - Negative Culture - Huh?

[familyof4]

I got a call last week from my son's school that he was in total meltdown. My child has never had separation anxiety. He has always been a very independant kid. His other episodes resulted in tics, frequent urination, ocd and rages but never separation anxiety. After the second day of meltdowns at school I took him in for a culture. The rapid was positive for strep. I am not sure why the office sent it in as well but the culture came back negative. How can this be?

 

Even after starting the antibiotics the anxiety got worse for the next two days. Last friday he got on the bus, tears streaming down his face, pressed his face to the window and made the "I love you" symbol with his fingers. It absolutely broke my heart. I think at this point I would much rather have the rages. Luckily he has a very understandig teacher this year at school.

 

How was the rapid positive but the culture negative?

[dcmom]

I did think I read somewhere, when I was researching strep tests, that it is possible. I would consider it strep, and treat it. If I find the info I was looking at, I will add a link...

[peglem]

Lab error? Maybe the culture swab didn't have enough "goo" on it? Did they do the swabs separately? I think there were times when my child showed negative just because the swab wasn't done well. My daughter really struggles and fights the swabbing, so sometimes they miss the right spot to get a good sample.

[colleenrn]

If the rapid was positive, he definitely has strep. What probably happened is they swabbed both swabs at the same time and the one they sent for a culture was the swab that did not touch the tonsils and throat enough. What did your doctor say about it? Is he responding to the antibiotics now?

Colleen

[familyof4]

My pediatrician is out of the office for a couple weeks so I haven't talked with her yet. The doc we saw for the culture and I didn't get along very well as she kept trying to prescribe an antibiotic that he is allergic to (even clearly says so in his medical file) because she felt it would clear up the strep better. I question why they even sent one in to be cultured since the rapid was positive. They did do both swaps at once. Should I ask them to be done one at a time instead? My son was really good for it and did not fight it.

 

This is my son's 4th pandas flare up in 2 years and this time he is not coming back to baseline as rapidly as the last time. He is better but still not himself.

[P_Mom]

Oh my gosh...that scene you described with the tears, the bus..the I love you sign...I would have lost it!! So sorry! Can I ask.....was he on preventative antibiotics? If so, which one?

 

Thank you so much......hope you get him back soon!!!

[familyof4]

I was a wreck after the bus left - I cried off and on all morning and beat myself up about whether or not I should have just kept him home. He cried most of the morning at school but had a better afternoon according to his teacher. Dealing with this has been harder on me than the rages and ocd were in the past.

 

The good news is that he made it through today without tears so hopefully that is a sign he is doing better. The bad news is that he had quit sucking his thumb months ago and now it is back - (not at school but at home and in the car). I was told it is related to the anxiety.

 

He is not on preventative antibiotics. He is allergic to all cephalosporins and augmentin. His pediatrician is concerned that overuse of any of the antibiotics that he can take (zithromax) might also result in an allergic reaction and leave him with nothing to take. If strep continues to be bad at school this year we may have to revisit that decision.

 

I do have my pediatrician on board to get the immune testing done at some point in the future. We have not tried the steriod burst yet so I still have that we can use as well.

[dcmom]

My daughter has had separation anxiety with her episodes. We have seen a psychologist to help us deal with some of the issues. She gave me and idea for going to school, which I didn't think would work, but it helped us tremendously.

 

My daughter basically likes school and her friends, but when pandas is flaring has a VERY hard time leaving me. We started a new routine of me walking her right into the classroom (all the kids walk to school- no buses). We get there a few minutes early, she has a chance to put her stuff away and give me a hug in her own time w/o the chaos of the other kids. By the time they come in, she is ready. On those mornings this is not enough (she cries, says she hates school and she is NOT going), I offer to come back at some point in the day (usually I choose lunch) and bring her home if she wants. I always stick to my word, and every time she wants to stay. By lunch, she is with her friends and more settled. (once or twice, she did want to come home from lunch- but I told her we would be going to the grocery store- she stayed). I am willing to bring her home if she needs to.

 

I didn't think it would work, but it worked like a charm. I don't know if it would work for you logistically. But if things get worse, keep it in mind...

[pixiesmommy]

In some preschools they have kids bring in pictures of family so they can look at them when they are feeling homesick/anxious, so that may be another idea. For Pixie, I would draw a small heart on her hand in ink and kiss it and tell her she had my kiss with her all day even if I was not there myself and that seemed to help some. She also would sometimes take something small of mine and keep it in her pocket.

 

I sympathize about the allergy- I, too, am allergic to almost all antibiotics and I worry about that for my kids. It makes it tough.