Streptococcus Pneumonae

[mom md]

WOW. My son Carter who has PANDAS had PEX this summer. He was cured. My other son got H1N1 with presumed Step. Pneumoniae superimposed. He had a very bad pneumonia and was in the hospital for 4 days. Exactly three weeks later my older son relapsed with his ASO at 500 and his anitDNase B at 700. His throat culture was negative. We have done one IVIG and are set to do another one 8 weeks form the first. He is doing well now. All very interesting.

[jewels]

Everytime we go back onto the lower dose daily Keflex we see a spike starting within 2 days. (cough starts first). The Drs know that she is fighting some form of lingering infection as her white blood count is >1 x 10L. As we found a kidney infection (proteous) which is hard to resolve, the Drs have been focusing on this as the infection cause.

 

Everytime she develops a sore throat we have been swabbing and its coming back as a strep infection. I can go to the hospital with a passport to be seen at any time, but we need to wait until next week to see our PANDAS dr, as he will be more understanding.

 

We do live in a very old house, but gutted it and rebuilt inside before the diddlies came along. It does seem to be some sort of infection due to the temperature rise.

 

Dr once did mention to me that a child with autoimmune issues can present with infections and viruses which are low grade and difficult to find. Didn't go into much detail about this, and I never questioned this.

[PatAnne]

Also check for complement deficiencies because it make it harder to fight! My son has a C4 deficiency and was hospitalized last spring with S pneumonia. The thing was that when I saw how ill he was I recognized that he had had this many times when younger and it was not diagnosed. It was the cyanotic look of him that I had definately seen before! He had very definate PANDAS symptoms at this time. An immuno at Hopkins when sent his pneumoccal antibody test result (only 1 sereotype) said PANDAS had NOTHING to do with it.

 

PatAnne

 

 

 

Everytime we go back onto the lower dose daily Keflex we see a spike starting within 2 days. (cough starts first). The Drs know that she is fighting some form of lingering infection as her white blood count is >1 x 10L. As we found a kidney infection (proteous) which is hard to resolve, the Drs have been focusing on this as the infection cause.

 

Everytime she develops a sore throat we have been swabbing and its coming back as a strep infection. I can go to the hospital with a passport to be seen at any time, but we need to wait until next week to see our PANDAS dr, as he will be more understanding.

 

We do live in a very old house, but gutted it and rebuilt inside before the diddlies came along. It does seem to be some sort of infection due to the temperature rise.

 

Dr once did mention to me that a child with autoimmune issues can present with infections and viruses which are low grade and difficult to find. Didn't go into much detail about this, and I never questioned this.

[simplygina]

Also check for complement deficiencies because it make it harder to fight! My son has a C4 deficiency and was hospitalized last spring with S pneumonia. The thing was that when I saw how ill he was I recognized that he had had this many times when younger and it was not diagnosed. It was the cyanotic look of him that I had definately seen before! He had very definate PANDAS symptoms at this time. An immuno at Hopkins when sent his pneumoccal antibody test result (only 1 sereotype) said PANDAS had NOTHING to do with it.

 

PatAnne

 

 

Curious. What does the "cyanotic look" looklike?

[nevergiveup]

This bug is also notoriously a cause of sinus infections. I would say this is definately my kids culprit because she has no antibody titers to the polysacharoid bugs and she has had over 41 sinus infections and four pneumonias in the last five years. SF Mom what abx are best for this, I know aug XR is by far the best drug for chronic sinus infections and it can take up to sixty days to erradicate the bug from the nose at high dose. Cefdinir seems also a good choice. B lactam abx I believe fight this the best, not necessarily the macl or azith? That would be better to mycoplasma.

 

 

quote name='SF Mom' date='Sep 26 2009, 10:11 AM' post='39304']

From my understanding its fairly difficult to be tested for S. pneumoniae and the hospital would 'most likely' need to be associated with a university to have proper testing equipment. Again, I've got an e-mail into Dr. Cunningham to figure out how we might be able to be tested.

 

Perhaps you are thinking of the STREP PNEUMOCOCCAL ANTIBODY TITER test. This is not looking for the actual bacteria but more of the response the body produces to the pneumococcal hence 'antibody titers'.

[jewels]

I'll take that onboard patAnne. She has the blue/red marks under her eyes and that very worn out look. We are due for more bloods and scans next week, but this time I'm going to thrown my dummy out of my pram and not leave until they test for the whole infection, deficiencies panel.

 

She has been at school in the past month for a total of two mornings due to this ongoing infection. We have to beg for tests here due to the cost of them! The Drs always say it has to be evidence based, which keeps the cost down

[PatAnne]

very pale, bluish/grey around the eyes and mouth.

 

PatAnne

 

Also check for complement deficiencies because it make it harder to fight! My son has a C4 deficiency and was hospitalized last spring with S pneumonia. The thing was that when I saw how ill he was I recognized that he had had this many times when younger and it was not diagnosed. It was the cyanotic look of him that I had definately seen before! He had very definate PANDAS symptoms at this time. An immuno at Hopkins when sent his pneumoccal antibody test result (only 1 sereotype) said PANDAS had NOTHING to do with it.

 

PatAnne

 

 

Curious. What does the "cyanotic look" looklike?

[zazuk2010]

I found this table on the cdc site. Apparently there was a very big rise in S. Pheumonae in Alaska (be interesting to know how many cases of PANDAS they have there). This data is from 2003 so it is a bit old, but still interesting. Unfortunitly I could not figure out how to post a chart in here, I previewed this and unfortunitly the dashes don't do the trick completly, but you can at least get the idea.

 

Antibiotic Resistance

Susceptibility testing was performed on all isolates in 2003. Results of the testing are presented in the

following table.

 

Table 9: Antibiotic Resistance in Invasive Streptococcus pneumoniae Isolates – Alaska, 2003

 

 

 

Antibiotic Susceptible------Intermediate--------Resistant--------I + R---------Total Tested

Penicillin 72 (81%)---------14 (16%)-----------3 (3%)----------17 (19%)-----89

TMP-sulfa 65 (73%)---------10 (11%)-----------16 (19%)--------26 (30%)----89

Erythromycin 83 (94%)----------0--------------------5 (6%)-----------5 (6%)------88

Ceftriaxone 86 (97%)----------3 (3%)--------------0-----------------3 (3%)-------89

Tetracycline 84 (94%)--------- 0--------------------5 (6%)-----------5 (6%)------89

Chloramphenicol 87 (98%)----------0------------------- 2 (2%)-----------2 (2%)------89

Rifampin 88 (100%)---------0------------------- 0------------------0------------88

Vancomycin 89 (100%)---------0--------------------0------------------0------------89

Levoflox 89 (100%)---------0--------------------0------------------0------------89

Clindamycin 77 (97%)----------0--------------------2 (3%)------------2 (3%)------79

 

 

 

here is the web address where I found this. good article to read. you can find the chart if you follow the link in the article titled "Surveillance Annual Reports"

 

link to article

[jewels]

Thankyou zazuk2010,

 

I also read it was on the increase and very hard to fight with abx. We are a month into cough/throat infections now and really had enough of drs passing it off as viral due to immune system low. They see the throat infection as a lingering one that the abx are not getting on top of.

 

The report was very interesting and I'm looking at trying to find some information here too. I know if I ask at hospital for them to look into any testing re;cough, then they will only do it if she is presenting with all the symptoms. This is why I have to wait and see her Ped.

 

I can understand that they don't like to put children under any invasive tests, but their comes a point where we have to know what is wrong.

 

 

Thanks again

Jules

[Fixit]

i tried reading this...but i don't understand.....

 

just got my sons strep pneumoniae back...there were 23...

 

9 were below 0.3

11 more are well below 2

only 3 were above 2

 

 

they are supposted to be 2 and above correct?

what does that mean?

the test doesn't say out of range, it does note the thing about a leve of 2

or does this mean nothing??

 

is that an immune deficiancy???

lack of response or ability to respond???

 

would that qualify him for ivig???

 

i would really like to hear from anyone who understands

[P_Mom]

Pass!

[kimballot]

So, I met with Diana Polhman yesterday for the first time. We live only a couple of miles apart and she has been helping me tremendously with my son. As most of you know, she met with Dr. Cunningham (STREP EXPERT) last week. It appears and hopefully I'm getting this right..... Dr. Cunningham believes it to be the type of strep. Not typical Streptococcus A but S. pneumoniae which is very difficult to rid the body of infection. Please read the definition below closely. If it is, it would explain why certain antibiotics are not that effective and why repeated IVIG is sometimes required.

 

My child had NEVER been sick until he was exposed to what we now to believe was Scarlet Fever. The first time my son was ever prescribed antibiotics was at 4 1/2...... so, only one year ago. He was healthy, healthy, healthy.

 

What are your thoughts? I hope to have my son tested for S. pneumoniae if possible. I understand its difficult to find someone to test. Plus he is now post IVIG.

 

Taken from Wikipedia

 

Streptococcus pneumoniae, or pneumococcus, is Gram-positive, alpha-hemolytic, bile soluble diplococcus aerotolerant anaerobe and a member of the genus Streptococcus.[1] A significant human pathogenic bacterium, S. pneumoniae was recognized as a major cause of pneumonia in the late 19th century and is the subject of many humoral immunity studies.

Despite the name, the organism causes many types of pneumococcal infection other than pneumonia, including acute sinusitis, otitis media, meningitis, bacteremia, sepsis, osteomyelitis, septic arthritis, endocarditis, peritonitis, pericarditis, cellulitis, and brain abscess.

 

S. pneumoniae is the most common cause of bacterial meningitis in adults and children, and is one of the top two isolates found in ear infection, otitis media.[2] Pneumococcal pneumonia is more common in the very young and the very old.

 

S. pneumoniae can be differentiated from other members of Viridans Streptococci, some of which are also alpha hemolytic, using an optochin test, as S. pneumoniae is optochin sensitive. S. pneumoniae can also be distinguished based on its sensitivity to lysis by bile. The encapsulated, gram-positive coccoid bacteria have a distinctive morphology on gram stain, the so-called, "lancet shape." It has a polysaccharide capsule that acts as a virulence factor for the organism; more than 90 different serotypes are known, and these types differ in virulence, prevalence, and extent of drug resistance.

 

WOW! I never read this post. This SOO explains my son's situation with chronic sinusitis from birth and S. Pnuemonia immune deficiency.

 

Is there anything in writing about this yeat? I NEED something in writing for the local docs who keep telling me that he does not have a GABHS infection, so he cannot have PANDAS. Is there an article that I missed?? Any help is GREATLY appreciated!!

[P_Mom]

No, this is NOT correct. Dr. Cunningham does not say that PANDAS is caused by S. Pneumonia bacteria. She said it is "possible" for it to cause a PANDAS episode, (at this point, anything is "possible")........but, that group A Strep is the "main" trigger.

 

S.Pnuemonia and group A strep are two totally different bacterias........testing for S. pnuemonia response does not predict your childs response to group A strep!

[AmySLP]

This post is so relevent to info we just got on our 5 1/2 y/o daughter. Dr. B tested 14 strep. pneumonae. My daughter was found to to have no immune response to 9 of the 14 serotypes. This led to a diagnosis of Specific Autoimmune Deficiency. He explained that the Prevnar vaccine alone should provide the immune response-she had four doses. She had strep at 8 wks, 3 months and two more time before 1st birthday. He explained that the reason some docs say babies can't get strep is that they should have immunue protection from the mother-it is likely that I have/had the same deficiency as she clearly did not have this protection. Her other immune numbers were excellent and she had titer rise with every other vaccine she received, some even higher response that the normal range. He explained that some children would have this same deficiency and never get PANDAS b/c he feels that there is a genetic disposition to it.

 

Hope this helps, trying to figure this all out myself as well...

Amy

[Fixit]

This post is so relevent to info we just got on our 5 1/2 y/o daughter. Dr. B tested 14 strep. pneumonae. My daughter was found to to have no immune response to 9 of the 14 serotypes. This led to a diagnosis of Specific Autoimmune Deficiency. He explained that the Prevnar vaccine alone should provide the immune response-she had four doses. She had strep at 8 wks, 3 months and two more time before 1st birthday. He explained that the reason some docs say babies can't get strep is that they should have immunue protection from the mother-it is likely that I have/had the same deficiency as she clearly did not have this protection. Her other immune numbers were excellent and she had titer rise with every other vaccine she received, some even higher response that the normal range. He explained that some children would have this same deficiency and never get PANDAS b/c he feels that there is a genetic disposition to it.

 

Hope this helps, trying to figure this all out myself as well...

Amy

 

was it this test alone that got you an "immune defiency" ore did it lead you somewhere else...

so what did you do?

did you revacinate?