Ongoing Sinus Infection after mos of abx and 4 ivigs?

[coco]

Hi all, something has had me puzzled for a few months now...my dd has been on abx (augementin, zithro, now back to augmentin) for 5 months now, and she has undergone 4 ivigs, first with Dr. K., and since then monthly with Dr. B. For the past several months she seems to have had the "sniffles and sneezing" or an "almost cold" without the wiped out for a day or so feeling that usually accompanies a cold. No fever. She has also had/has some reddish cold sore looking sores on the end of her nose (but no blisters or oozing), in her nose and right under her nose. This sort of comes and goes, but every time I see it getting redder I wonder, "what IS this??" I have sent pics of it to Dr. K, who thought it was may be "viral impetigo" -- Dr. B never saw her when she had it, but he thought it could be cold sores...I thought cold sores always came around the mouth and blistered? Anyway, my question is, could this be a sinus infection -- but she's been on high abx and ivig for 5 months, should she be having this recurrent problem?? Dr. B says ivig will take care of viral issues, Dr. K says ivig will not. What is your experience and advise? My daughter goes for ivig #5 in early January. Thanks everyone.

[sf_mom]

Have you done the high dose IVIG more than once per Dr. K's protocol? How much does your daughter weigh and what antibiotic and strength is she currently taking? Is she improving overall minus the sores?

 

-Wendy

[coco]

Dr. B is doing almost as much gamma as Dr. K., she is currently on 1200 augmentin and she is doing a 30-day prednisolone dose and is doing much better, behaviorally. The prednisolone really gave things a shot in the arm and she is responding very well...maybe this will help her over the rough patches, but this sinus -- or almost cold -- and sores makes me really wonder what's going on inside.

[coco]

My dd weighs 60 lbs.

[Alex]

Have you seen an ENT for a sinus scope or X-ray? Might be a good way to fing out if there is any sinus problem.

[thereishope]

I think they can do a CT scan of the sinuses to see if there is an infection hiding out. I would think the ENT would do that. If there is and abx won't get rid of it, I think they can do more invasive measures and actually go and drain the cavities and that would help the meds work better.

 

My son had the ongoing on and off cold w/ a slightly runny nose and his voice seemed off. Like it was affected by swelling. They did say it was a sinus infection. The first abx didn't work, but the Augmentin seemed to work. But he also hasn't had many issues with abx. He just finished the script yesterday so I'm waiting to see if it creeps backs, which other moms have told me can happen after they go off the meds for it.

 

As for the nose, if it's constantly wet and he's wiping it with his hands and sleeves, that will cause irritation. Are you putting a topial antibiotic on it? Are his hands red and rashy from wiping it?

[coco]

But I wonder WHY after 5 months of high abx and 4 ivigs she is still having this. Her nose is not red from wiping, it's more at the tip of her nose and they are clusters of sores that are not crusty, but red...almost going to get crusty if it ever got worse. It's amazing to me that after all these abx the infection could STILL be so stubborn that it's not eradicated...and, does that mean the brain is having an equally hard time of healing?

[sf_mom]

Its so hard to say...... but I think it would be worth switching to azithromycin or upping the current dose of augmentin. My son has been on and off higher dose of antibiotics post IVIG and every time we've upped the dose he becomes symptomless and every time we've lowered the TICs reappear (all within 48 hours). His main presentation at sudden-on set was TICS. We've done this at least three times. The higher dose is working so I'm not changing a thing. He is 45 pounds and on 500 m.g. of azithromycin currently.

 

From everything I've read and if its truly one of the more difficult strains of strep to eradicate you have to stay ahead of its growth. BUT, its my perspective, as long as you are seeing continued improvement she is ahead of the underlying infection.

 

-Wendy

[harmony]

But I wonder WHY after 5 months of high abx and 4 ivigs she is still having this. Her nose is not red from wiping, it's more at the tip of her nose and they are clusters of sores that are not crusty, but red...almost going to get crusty if it ever got worse. It's amazing to me that after all these abx the infection could STILL be so stubborn that it's not eradicated...and, does that mean the brain is having an equally hard time of healing?

It could not be reacting because it is the wrong type of antibiotic. Do you have an immunologist? Our immunologists gets very angry at our pediatrician for giving wrong types of antibiotics for sinus infections. My son was on Augmentin for 2 1/2 months for sinus infection- given by ped.- it still was not better. We went to the immunologist - she put him on another type- cured within 10 days.

 

But I guess it has to hard to treat, if no one knows what it is. I would suggest an ENT or Immunologist. If that doesnt work- it may be dermatology related.

[Debbie1]

Hi coco,

 

Any chance it could be allergy related? My dd has been on many months of antibiotics as well, and still often has a runny nose. My kids never test positive to skin testing (even though they have had confirmed food allergies), so although negative, we still aren't sure it isn't allergy related.

 

Let me know if you are able to uncover the root of the problem. Gotta run - I have 3 kids recovering from t&a surgery.

 

Debbie

[thereishope]

Allergies is a trigger for my son. Shortly after his third strep triggered exacerbation, he had a big setback. It sent us to the dr for a strep test (came back negative) and then on our way to the psychiatrist and psychologist. Then we realized it was allergies. His only symptom was very red eyes. To the point there was no white in them. The worsening in PANDAS symptoms preceded the eyes only by a matter of days. Once I got the red eyes under control with allergy meds, the behaviors were more calmer and we were back on the road to recovery.

[coco]

Ok, my dd just went to the bathroom...Iwanted to check out her stools (which I do from time to time, just to be sure no abnormal) and I got a really good look at her bottom and I SEE A RED RASH ALL OVER IT!!! Is this a yeast rash?? I have never seen this before, but then again it's been a long time since I have glared at her bottom. Is this the culprit of the sinus problem?? Ironically, I just bumped up the probiotics this afternoon on all your input of "maybe yeast." What do you all think?

[coco]

Or is it Strep A rash on her bottom??!! How do I tell the difference? This is maddening.

[KeithandElizabeth]

Dr. K once suggested that I have my daughter's anal area swabbed for strep. I would recommend doing that with your daughter tomorrow just to be sure....

 

Elizabeth

[momto2pandas]

This could be allergic, as well. Has she been checked for food allergies? Those have caused both sinus issues and bottom rashes for both of my sons.

 

 

Or is it Strep A rash on her bottom??!! How do I tell the difference? This is maddening.