Streptococcus Pneumonae

[Fixit]

My DS also has deficiencies of 13 out of 14 of the S. pneumoniae titers. He has normal ASO but elevated anti DNASE. I understand that this will help with insurance for IVIG, but I am curious as to whether there is an actual meaning to this. As far as I know, DS hasn't gotten Prevnar (unless it is one of the standard immunizations?) Does that mean that the titers are irrelevant?

 

yes it is stardard...

there are 4 shots...

[AmySLP]

My DS also has deficiencies of 13 out of 14 of the S. pneumoniae titers. He has normal ASO but elevated anti DNASE. I understand that this will help with insurance for IVIG, but I am curious as to whether there is an actual meaning to this. As far as I know, DS hasn't gotten Prevnar (unless it is one of the standard immunizations?) Does that mean that the titers are irrelevant?

 

 

It is a "standard" vaccine with four doses. I happened to add my daughter's vaccine record to her PANDAS binder the morning of our appt with Dr. B-and it felt great when he asked if she had had the four doses and I had the info right there. I was worried b/c I spaced her vaccines considerably, but he said it didn't matter as long as she had gotten the 4 doses.

[DonnaD]

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.

My daughter had a reaction to Prevnar vaccine. She developed a rash on the palms of her hands and feet. The doc's reported it to CDC. I wonder what that was? She never received follow-up.

[kim]

lynn,

 

PCV (pneumococcal conjugate vaccine) wasn't around until the year 2000. I think your son was too old to have received the series?

 

There is good discussion on this subject here

 

http://www.latitudes.org/forums/index.php?...c=6469&st=0

 

Notice Busters comment

 

It does seem remarkable to me that this vaccine could have so much use and not have good data on the duration of protection past 18m post last vaccination.

[kimballot]

lynn,

 

PCV (pneumococcal conjugate vaccine) wasn't around until the year 2000. I think your son was too old to have received the series?

 

There is good discussion on this subject here

 

http://www.latitudes.org/forums/index.php?...c=6469&st=0

 

Notice Busters comment

 

It does seem remarkable to me that this vaccine could have so much use and not have good data on the duration of protection past 18m post last vaccination.

 

does anyone know the difference between the pneumovax and the prevnar?? I am not sure of the difference, but docs often ask me which my son had. I believe my son had two pneumovax injections around 2000 and 2001 - and I believe my niece had a pneumovax around 1994 (I believe she was among the first in our area to have one). The pneumovax was only given to kids with S.Pneumoniae deficiency from what I can recall.

 

I beleive the prevnar started to be used in the mid 2000's in our area. My kids (born 1995 and 1997) did not have prevnar.

[lynn]

I beleive the prevnar started to be used in the mid 2000's in our area. My kids (born 1995 and 1997) did not have prevnar.

 

 

Yes, DS was born in 1995, so likely (don't have records with me but will check) he would not have had the vaccine. Does that make the fact that he has no antibodies to any of the S. pneu. (13 out of 14 were considered unprotective) irrelevant, or would he likely have been exposed through modern life anyway?

[kimballot]

Yes, DS was born in 1995, so likely (don't have records with me but will check) he would not have had the vaccine. Does that make the fact that he has no antibodies to any of the S. pneu. (13 out of 14 were considered unprotective) irrelevant, or would he likely have been exposed through modern life anyway?

 

Lynn - I am no expert on this subject, but here is what I am learning:

It seems to me that being below protective levels in 13/14 titers is pretty significant. I am guessing that if he never had pneumovax or prevnar the insurance company would want him to try that before they approved IVIG.

 

Are you trying to get IVIG approved?

 

I was heartily warned by nevergiveup and others to NOT go to a standard immunologist because they would try to do another pnueumovax to boost the numbers - then say he is no longer immune deficient. (see http://www.latitudes.org/forums/index.php?...p;hl=kimballot)

 

That is why we started with Dr. B. My understanding is that Dr. B has been able to get IVIG without having to do the repeated pneumovax.

 

I am not sure what the outcome of a pnuemovax or prevnar would be for you since you're son has never had one, but I would check with a PANDAS doc first.