Group B Strep in throat

[harmony]

Just a few hours ago I responded to the post about vaccines and symptoms exaccerbations.

Well now I know it was not because of vaccine. But because of Group B strep throat. (He has had 2 group A strep infections and now 1 group B strep in 3 months)

I do not understand what this means, so I call:

His Infectious Disease Dr.- she just read something out of a book and didnt even answer my questions "sorry, I couldn't help"

CDC- passed me to 3 different people- untill they finally said "I will have a specialist call you back within 24 hours, I am not able to find any of your answers"

ENT- " i will have to get back to you"

 

So......once again, no help from doctors. Maybe someone here can help.

 

 

 

1) What is the difference between Group B strep and Group A strep?

 

2) His legs have been hurting the last few days, sometimes so badly that he has to sit and feels like he can't walk. He has also developed a "seal like " cough. Could this be related?

 

3) He is scheduled for a tonsilectomy on Thursday, does this need to be canceled because of the risk of Group B in his bloodstream? (His ENT has not even anwered this question yet- "I will get back to you")

 

 

 

Any responses would be greatly appreciated.

Thanks

[dcmom]

Hi Harmony- Sorry you are going through this. I also had an ID doctor read to me from a book once- thanks, I could do that!

 

A few thoughts/questions:

 

Is your son sick now/ infected?

 

If so, I would think hold off on the surgery- that is a mommy gut feeling suggestion, no more.

 

Is he currently on antibiotics?

 

I would suggest (regardless of this current issue): 10 days of daily antibiotics prior to and post T&A (at a minimum) and IV antibiotics while in hospital. (My daughter had a pandas episode post T&A.)

[harmony]

Hi Harmony- Sorry you are going through this. I also had an ID doctor read to me from a book once- thanks, I could do that!

 

A few thoughts/questions:

 

Is your son sick now/ infected?

 

If so, I would think hold off on the surgery- that is a mommy gut feeling suggestion, no more.

 

Is he currently on antibiotics?

 

I would suggest (regardless of this current issue): 10 days of daily antibiotics prior to and post T&A (at a minimum) and IV antibiotics while in hospital. (My daughter had a pandas episode post T&A.)

My son had a group A strep infection in the beginning of November. His PANDAS symptoms lasted around 2 weeks and then went away (for the most part).

One week after remission his PANDAS symptoms came back FULL force. A week or two later- I took him back to ped. (Last Thursday- 5 days ago) "something, is still not right. His behaviors and tics are back" I think he may still have a strep infection and I would like an antibiotic before surgery". She assured me "no way possible for him to have another strep infection, he just finished 10 days augmentin. I will not over prescibe antibiotics, why do you want antibiotics before surgery when he clearly doesnt have an infection?" I demanded another culture. After leaving her office, I began thinking "maybe she is right, maybe he doesnt need antibiotics before, maybe I am just a crazy paranoid mom, maybe his behavior is just a result of the vaccine a few days ago."

 

Since then His PANDAS symptoms have decreased greatly - but has gained the cough and leg pains.

I am kind of worried about this- the last time his PANDAS symptoms decreased at the SAME his Physical illness increased- he developed HSP. It was like the antibodies left his brain and then attacked his blood vessels. Has anyone experienced this?

I am sure he will be fine- I just don't have any faith in dr's anymore

[Worried_Dad]

Hi, Harmony:

 

When my son 1st got sick, his symptoms began with joint pain and muscle weakness, especially in his legs. This sounds very much like the "rheumatic fever" end of the spectrum vs. pure PANDAS.

 

Here's a post about our experience with our son (and a much earlier illness we now suspect was related):

 

http://www.latitudes.org/forums/index.php?...ost&p=35624

 

Never had the cough, though, although he's had various vocal tics. Could it possibly be a tic, or is it a "productive" cough?

 

Hope you get better answers and that the tonsillectomy helps!

[PatAnne]

Hi,

 

My son had HSP twice at age 5, once caused by staph infection in his ear, the other we think strep. Srtep causes HSP in up to 50% of cases which I never knew. It was awful. It was only a few years ago our allergist found my son had a VERY low C4 level (8) and a low IgGsubclass 1 (also an IgE of 1200 which is common for him). Low C4 is associated with HSP, especially multiple episodes. Have you ever had C3 and C4 tested?

 

Our allergist was sure he would need IVIG, but the immuno we saw at Hopkins said he was just "unlucky" as far as his immune system functioning goes! This is a kid who cannot go off antibiotics without falling completely apart! In any case, we will re-test next week and what things look like now.

 

PatAnne

 

 

 

 

Hi Harmony- Sorry you are going through this. I also had an ID doctor read to me from a book once- thanks, I could do that!

 

A few thoughts/questions:

 

Is your son sick now/ infected?

 

If so, I would think hold off on the surgery- that is a mommy gut feeling suggestion, no more.

 

Is he currently on antibiotics?

 

I would suggest (regardless of this current issue): 10 days of daily antibiotics prior to and post T&A (at a minimum) and IV antibiotics while in hospital. (My daughter had a pandas episode post T&A.)

My son had a group A strep infection in the beginning of November. His PANDAS symptoms lasted around 2 weeks and then went away (for the most part).

One week after remission his PANDAS symptoms came back FULL force. A week or two later- I took him back to ped. (Last Thursday- 5 days ago) "something, is still not right. His behaviors and tics are back" I think he may still have a strep infection and I would like an antibiotic before surgery". She assured me "no way possible for him to have another strep infection, he just finished 10 days augmentin. I will not over prescibe antibiotics, why do you want antibiotics before surgery when he clearly doesnt have an infection?" I demanded another culture. After leaving her office, I began thinking "maybe she is right, maybe he doesnt need antibiotics before, maybe I am just a crazy paranoid mom, maybe his behavior is just a result of the vaccine a few days ago."

 

Since then His PANDAS symptoms have decreased greatly - but has gained the cough and leg pains.

I am kind of worried about this- the last time his PANDAS symptoms decreased at the SAME his Physical illness increased- he developed HSP. It was like the antibodies left his brain and then attacked his blood vessels. Has anyone experienced this?

I am sure he will be fine- I just don't have any faith in dr's anymore

[kim]

harmony,

 

We had another parent on the TS forum a while back who said that her daughter got petechiae and purpura with strep infections. I don't remember ever seeing either of these on my boys, but after I had my rash last winter (related to an infection in an elbow where I had psoriasis) I noticed those tiny bright red spots this summer. I have been wondering if anyone else sees either of these conditions. I know we had another mom who reported that her daughter got bruises on her thighs from leaning on them during basketball practice, if i remember right. Also, I read somewhere recently that the cephlosporins could cause some kind of a immune complex with the blood vessels. I should probably find that and post it. Anyway, just wanted to let you know that purpura type reactions have been reported a couple of times. Also, don't know if you are familiar with Dr.Amy Yasko (practices more along the lines of DAN protocols), but she says strep depletes vit K levels.

[matis_mom]

Just a few hours ago I responded to the post about vaccines and symptoms exaccerbations.

Well now I know it was not because of vaccine. But because of Group B strep throat. (He has had 2 group A strep infections and now 1 group B strep in 3 months)

I do not understand what this means, so I call:

His Infectious Disease Dr.- she just read something out of a book and didnt even answer my questions "sorry, I couldn't help"

CDC- passed me to 3 different people- untill they finally said "I will have a specialist call you back within 24 hours, I am not able to find any of your answers"

ENT- " i will have to get back to you"

 

So......once again, no help from doctors. Maybe someone here can help.

 

 

 

1) What is the difference between Group B strep and Group A strep?

 

2) His legs have been hurting the last few days, sometimes so badly that he has to sit and feels like he can't walk. He has also developed a "seal like " cough. Could this be related?

 

3) He is scheduled for a tonsilectomy on Thursday, does this need to be canceled because of the risk of Group B in his bloodstream? (His ENT has not even anwered this question yet- "I will get back to you")

 

 

 

Any responses would be greatly appreciated.

Thanks

Harmony,

A few questions... how did they find the Group B strep in his throat??? Is it the same swab they do for A?

About those leg pains, are they joint pains, or just overall leg pain?

 

From my experience, I would not go ahead with the T&A until I get some clear answers. I would definitely have that cough checked out, it could be pneumonia. There has been a lot of cases around here, mostly people getting it a couple of weeks of having had the flu. It is also caused by strep, and a couple of our friends had their kids go downhill very fast. They recovered just fine after some heavy meds, so I don't want to scare you, but you can't ask your body to deal with too many things at the same time. If anything, I would wait and see how he does.

For our son, recovery after the T&A was painful and slow, so I would say it's not something to go into if you are not feeling well to begin with.

Keep us posted and I hope he either just gets better, or you get some clear answers from the docs!

[dabel]

harmony,

 

We had another parent on the TS forum a while back who said that her daughter got petechiae and purpura with strep infections. I don't remember ever seeing either of these on my boys, but after I had my rash last winter (related to an infection in an elbow where I had psoriasis) I noticed those tiny bright red spots this summer. I have been wondering if anyone else sees either of these conditions. I know we had another mom who reported that her daughter got bruises on her thighs from leaning on them during basketball practice, if i remember right. Also, I read somewhere recently that the cephlosporins could cause some kind of a immune complex with the blood vessels. I should probably find that and post it. Anyway, just wanted to let you know that purpura type reactions have been reported a couple of times. Also, don't know if you are familiar with Dr.Amy Yasko (practices more along the lines of DAN protocols), but she says strep depletes vit K levels.

 

 

That is interesting! My son's Vitamin K levels were low when we checked his Aso etc.

 

DeAnn

[sf_mom]

Harmony: Please DO NOT MOVE forward with T & A. It does sound like it could be Rheumatic Fever or Kawasaki's

 

PLEASE HAVE THE FOLLOWING TEST DONE IMMEDIATELY:

 

Abnormal Lab findings that would be elevated for RF: WBC, Netrophilis, C-Reactive Protein, ESR, Anti-DNase-B Titers, PNEUMOCOCCAL AB TITER 14 SUBTYPES (deficiencies)..... If there are no TITERS Anti-DNase-B its most likely Kawasaki's.

 

They have been unable to eradicate the strep and that is why he keeps testing positive. Symptoms to check for on your son... sand papery rash, rash, swollen gland on one side 'neck, face, etc', chapped lips, mouth sores, pink eye/red eyes both eyes, peeling hands or feet 'starts at finger tips or toes' can come off in sheets, rash at groin. Did he ever run a fever for more than 4 days without relenting?

 

There are delayed responses so reflect over the past 3 months of illnesses... If its Kawasaki's they will treat him immediately with IVIG and it will be covered.

 

-Wendy

[harmony]

Just a few hours ago I responded to the post about vaccines and symptoms exacerbations.

Well now I know it was not because of vaccine. But because of Group B strep throat. (He has had 2 group A strep infections and now 1 group B strep in 3 months)

I do not understand what this means, so I call:

His Infectious Disease Dr.- she just read something out of a book and didn't even answer my questions "sorry, I couldn't help"

CDC- passed me to 3 different people- until they finally said "I will have a specialist call you back within 24 hours, I am not able to find any of your answers"

ENT- " i will have to get back to you"

 

So......once again, no help from doctors. Maybe someone here can help.

 

 

 

1) What is the difference between Group B strep and Group A strep?

 

2) His legs have been hurting the last few days, sometimes so badly that he has to sit and feels like he can't walk. He has also developed a "seal like " cough. Could this be related?

 

3) He is scheduled for a tonsillectomy on Thursday, does this need to be canceled because of the risk of Group B in his bloodstream? (His ENT has not even answered this question yet- "I will get back to you")

 

 

 

Any responses would be greatly appreciated.

Thanks

Thanks everyone for your responses.

to answer some of the question:

 

He was given Clindamycin 150 mg 3X daily to treat.

No, he hasn't shown any other symptoms, no rash, swollen glands, etc. I will be keeping a close eye on him though!

His legs have been sore, not his typical knee pain that he gets with infections (one of his common PANDAS symptoms) - this is completely different.

Other than that there are no other signs of reoccurring HSP- this is something I fear as much as PANDAS symptoms- I am always on the "lookout". He has only had it once- it was horrible- swollen sore feet (couldnt walk), rash, extreme stomach pain that sent us rushing to hospital- thank goodness he only had a small amount of protein/blood in urine- it did not cause perminant kidney damage- but we were all so scared- I had never seen him in that much pain.

 

Even though the Dr. said he could still have the surgery, I decided to postpone it until Spring- thanks for all of the advice! I agree- his body needs a break!

Also, I plan calling his Immunologist and request all of the blood work that was suggested- Do you think the antibiotics will effect results?

 

Still havent gotten any answers from CDC. This is kind of scary.

 

Thanks again for the support!

[harmony]

Harmony: Please DO NOT MOVE forward with T & A. It does sound like it could be Rheumatic Fever or Kawasaki's

 

PLEASE HAVE THE FOLLOWING TEST DONE IMMEDIATELY:

 

Abnormal Lab findings that would be elevated for RF: WBC, Netrophilis, C-Reactive Protein, ESR, Anti-DNase-B Titers, PNEUMOCOCCAL AB TITER 14 SUBTYPES (deficiencies)..... If there are no TITERS Anti-DNase-B its most likely Kawasaki's.

 

They have been unable to eradicate the strep and that is why he keeps testing positive. Symptoms to check for on your son... sand papery rash, rash, swollen gland on one side 'neck, face, etc', chapped lips, mouth sores, pink eye/red eyes both eyes, peeling hands or feet 'starts at finger tips or toes' can come off in sheets, rash at groin. Did he ever run a fever for more than 4 days without relenting?

 

There are delayed responses so reflect over the past 3 months of illnesses... If its Kawasaki's they will treat him immediately with IVIG and it will be covered.

 

-Wendy

I forgot to put this is my last post-

I actually got Rhuematic Fever from the same Strep stand that caused his FIRST PANDAS episode.

VERY painful shoulder and wrist pain.

I am going to try to get immunologist to do the test- I am not very happy with the ped. right now. She thought I was crazy for suggesting antibiotics pre-surgery (the ENT refused as well) even though I suspected strep again. Good thing she tested him - even though she only did it because I demanded it.

Thanks again.

[harmony]

Hi, Harmony:

 

When my son 1st got sick, his symptoms began with joint pain and muscle weakness, especially in his legs. This sounds very much like the "rheumatic fever" end of the spectrum vs. pure PANDAS.

 

Here's a post about our experience with our son (and a much earlier illness we now suspect was related):

 

http://www.latitudes.org/forums/index.php?...ost&p=35624

 

Never had the cough, though, although he's had various vocal tics. Could it possibly be a tic, or is it a "productive" cough?

 

Hope you get better answers and that the tonsillectomy helps!

I forgot to add this to my last post- Thank you so much for the link. I never really thought about the RF- I guess because he doesnt have the typical polyarthritis like I had when I had RF.

I do not believe the cough is a tic- he has had vocal tics in the past- this sounds very real- like croup!

I will definately ask the immunologist what she thinks and if there are RF tests we can do.

Thank you so much for your help and concern!

[sf_mom]

Harmony, Your son sounds very ill... especially, if you got RF from one of his prior episodes. You have to have him tested. The antibiotics should not effect results but the fact that he might have been misdiagnosed might.

 

Keep us post and so grateful you postponed T & A.

 

-Wendy

[EAMom]

She assured me "no way possible for him to have another strep infection, he just finished 10 days augmentin. I will not over prescibe antibiotics, why do you want antibiotics before surgery when he clearly doesnt have an infection?" I demanded another culture. After leaving her office, I began thinking "maybe she is right, maybe he doesnt need antibiotics before, maybe I am just a crazy paranoid mom, maybe his behavior is just a result of the vaccine a few days ago."

 

I would definitely get a good workup by an immunologist.

 

I think you might have a better chance of getting long term abs from an immunologist as well. Pediatricians (in our experience) are very fearful of antibiotics. When I asked our immunologist about this he said he felt it was safe for our dd (54 pounds) to stay on Azith (250mg/day) for years. When I asked about other docs (mainly the peds we've seen) have been against the abs, he said that pediatricians have been taught to be unnecessarily fearful of antiibotics.

 

For us, we finially got our ped "on board" with the long term antibiotics after going to specialists that agreed with our using them long term (ocd specialist child psychiatrist, pediatric neurologist, pediatric rheumatologist, pediatric immunologist).

 

Are YOU on long term anti-biotics (b/c of RF?). The rheumatologist we saw, described PANDAS as "rheumatic fever of the brain."

 

Where do you live? Can you see someone like Dr. Bouboulis and/or Trifiletti?