Titer levels

[harmony]

Is it necessary to test for titers after a positive culture?

I have heard so many people say different things.

My son has not had his titers checked in 4 years-both tests (ASO and AntiDNAse) came back negative even after a positive culture- but the blood was taken within days of the positive culture.

 

He is recovering from a very bad strep infection in his sinuses right now- he is clearly not back 100% (neurologically) yet- should I do the blood work? If so, what would be the point?

[ajcire]

Don't titers take time to rise? So if taken right after an infection they could be low but then rise a few weeks later?

 

 

 

Is it necessary to test for titers after a positive culture?

I have heard so many people say different things.

My son has not had his titers checked in 4 years-both tests (ASO and AntiDNAse) came back negative even after a positive culture- but the blood was taken within days of the positive culture.

 

He is recovering from a very bad strep infection in his sinuses right now- he is clearly not back 100% (neurologically) yet- should I do the blood work? If so, what would be the point?

[dcmom]

Harmony- I would say no. My dd had a positive culture at onset. We did titers once- they were normal. I was told early on by a Dr that worked with Swedo not to bother with titers- that they don't correlate with symptoms. It is a lot of bloodwork on a usually anxious kid for no gain.

 

I try to limit bloodworks, and use the bar- if this is not going to affect our course of treatment, then we don't do it. (of course, early on, some things need to be ruled out)

[Joan Pandas Mom]

Hi Harmony, I found the titers helpful because my son didn't test positive for Group A Strep but did test post. for Non-group A Strep. His titer was 1,014 though. Although he didn't have active Group A in his throat, he had had a previous infection. There is a lot of controversy about the titers. I am finding them helpful to know in treating my son, but he is 15 now. I did try to avoid them in the past and in hindsightI am wondering if the 1 time his culture was negative if his ASO was elevated. This was before I definitely knew he was PANDAS.

[EAMom]

Here's some info on titers: http://www.latitudes.org/forums/index.php?...st=0#entry29483

 

In your case, drawing titers would not be too helpful, since you already have a positive culture (proof of strep). Sometimes titers are helpful if you are unable to get a positive culture and are looking for evidence of a (possibly past) strep infection.

 

Yes, a titer a few days after a culture is too soon to see a rise. You could recheck in a few weeks to see the direction of the titers (since the titers you just did might serve as some sort of "baseline")...but he might not have a rise if he was placed on abs, or he might just be one of those kids that doesn't get elevated titers. And since you already have "proof of strep", the titers aren't really necessary in the first place.

 

My dd never got elevated titers despite measuring at the appropriate time...8 weeks after FEVER/strep exposure, positive cultures (8 weeks after FEVER/beh. change), and PANDAS severe enough to require hospitalization (acute food refusal, malnutrition, anorexia).

[harmony]

Thank you so much for all your replies!

[reactive]

Is it necessary to test for titers after a positive culture?

I have heard so many people say different things.

My son has not had his titers checked in 4 years-both tests (ASO and AntiDNAse) came back negative even after a positive culture- but the blood was taken within days of the positive culture.

 

He is recovering from a very bad strep infection in his sinuses right now- he is clearly not back 100% (neurologically) yet- should I do the blood work? If so, what would be the point?

Harmony: How do you test for a strep infection in the sinuses? I really want to know because I think that may have happened to my ds9 last month; when our doctor gave him antibiotic for strep "smell" and negative throat culture. You could smell the strep on him, he continually has sinus snorting and such, hard to sleep ect. But last month was worse and the smell. The smell went away after antibiotics.

[harmony]

Harmony: How do you test for a strep infection in the sinuses? I really want to know because I think that may have happened to my ds9 last month; when our doctor gave him antibiotic for strep "smell" and negative throat culture. You could smell the strep on him, he continually has sinus snorting and such, hard to sleep ect. But last month was worse and the smell. The smell went away after antibiotics.

They (ENT) swabbed his nose. Yes his breath smelled like rotten meat- i don't know if it was strep in particular that i smelled or just the "general infection". His immunologist, and all the ER staff noticed then mentioned his smell as well.