Hives definitely caused by strep

[AmySLP]

Thanks to all of you who gave me the belief that hives can be a symptom of strep that I felt comfortable enough saying I thought the test was necessary prior to leaving the peds. office.

 

After 4 solids days of worsening welt-like hives that covered every surface of my daughter's body, and isolated fevers off and on for a few weeks absent of any other symptoms, the culture came back positive. Our ped. was going to refer me to an allergist. He was shocked to find the quick test positive, which made me immediately tear up. When he said she's got strep I thought here we go... back to the nightmare of PANDAS. I thought we had really left this PANDAS/strep behind us~ it's just days shy of one year without a positive strep test. We saw Dr. Latimer on April 2nd of last year. Clindamycin was successful for Allison last year, so he chose to go right to that, as scary as the potential side effects are. I hope we caught this early enough to avoid the return of her PANDAS symptoms. I'm wondering where we go from here...back to regular strep testing, prophylaxis ABX? This isn't a trip I wanted to take again! Amy

[dut]

Hi - sorry to hear you are back in this position but at least you are on it and can deal with it. Good luck, hope she gets well and stays well...

[fuelforall]

Hi - sorry to hear you are back in this position but at least you are on it and can deal with it. Good luck, hope she gets well and stays well...

 

 

What are those scary side effects of Clindamycin exactly? I understand you don't want to be on it long term but....

[peglem]

He was shocked to find the quick test positive, which made me immediately tear up. When he said she's got strep I thought here we go... back to the nightmare of PANDAS. I thought we had really left this PANDAS/strep behind us~ it's just days shy of one year without a positive strep test.

 

I'm so sorry! This is exactly, exactly my reaction the last time my daughter had a positive strep test.

[Buster]

Thanks to all of you who gave me the belief that hives can be a symptom of strep that I felt comfortable enough saying I thought the test was necessary prior to leaving the peds. office.

 

After 4 solids days of worsening welt-like hives that covered every surface of my daughter's body, and isolated fevers off and on for a few weeks absent of any other symptoms, the culture came back positive. Our ped. was going to refer me to an allergist. He was shocked to find the quick test positive, which made me immediately tear up. When he said she's got strep I thought here we go... back to the nightmare of PANDAS. I thought we had really left this PANDAS/strep behind us~ it's just days shy of one year without a positive strep test. We saw Dr. Latimer on April 2nd of last year. Clindamycin was successful for Allison last year, so he chose to go right to that, as scary as the potential side effects are. I hope we caught this early enough to avoid the return of her PANDAS symptoms. I'm wondering where we go from here...back to regular strep testing, prophylaxis ABX? This isn't a trip I wanted to take again! Amy

 

Amy, because of the positive culture and the "hives" you should also get an echocardiogram.

 

The major symptoms of ARF are:

• Migratory polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
  
• Carditis: inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
  
• Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
  
• Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle. This rash never starts on the face and it is made worse with heat.
  
• Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms. This can occur very late in the disease.
  

if any two of these are true, that is sufficient for a diagnosis of ARF. It did not look like the "hives" are the subcutaneous nodules but worth checking with an ARF specialist.

 

Best regards,

 

Buster

[matis_mom]

The major symptoms of ARF are:

• Migratory polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
  
• Carditis: inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
  
• Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
  
• Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle. This rash never starts on the face and it is made worse with heat.
  
• Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms. This can occur very late in the disease.
  

if any two of these are true, that is sufficient for a diagnosis of ARF. It did not look like the "hives" are the subcutaneous nodules but worth checking with an ARF specialist.

 

Best regards,

 

Buster

Buster,

Do you have a full reference for this list? I am so mad Back in 2006 my son presented the subcutaneous nodules, had an eye-blinking tic, and a heart-murmur was detected for the first time, and NO ONE put 2 + 2 together!!! I just don't get how doctors can dismiss something that COULD be a symptom of something pretty nasty. I have been looking for references on RF but never saw one that described my son's wrist so well. I'd love to have a good reference to bring to the doctor next time.

Also, how do I find an ARF specialist???

 

Thanks!

 

Isabel

[Buster]

Do you have a full reference for this list? I am so mad Back in 2006 my son presented the subcutaneous nodules, had an eye-blinking tic, and a heart-murmur was detected for the first time, and NO ONE put 2 + 2 together!!! I just don't get how doctors can dismiss something that COULD be a symptom of something pretty nasty. I have been looking for references on RF but never saw one that described my son's wrist so well. I'd love to have a good reference to bring to the doctor next time.

 

The list is what is known as the JONES critieria for Acute Rheumatic Fever. Tjhe quickest link is probably the mayo clinic web page at: http://www.mayoclinic.org/rheumatic-fever/diagnosis.html

 

 

Also, how do I find an ARF specialist???

That is typically a reference from your pediatrician -- they'll know folks who specialize in Acute Rheumatic Fever -- typically a rheumatologist.

 

Buster

[matis_mom]

Do you have a full reference for this list? I am so mad Back in 2006 my son presented the subcutaneous nodules, had an eye-blinking tic, and a heart-murmur was detected for the first time, and NO ONE put 2 + 2 together!!! I just don't get how doctors can dismiss something that COULD be a symptom of something pretty nasty. I have been looking for references on RF but never saw one that described my son's wrist so well. I'd love to have a good reference to bring to the doctor next time.

 

The list is what is known as the JONES critieria for Acute Rheumatic Fever. Tjhe quickest link is probably the mayo clinic web page at: http://www.mayoclinic.org/rheumatic-fever/diagnosis.html

 

 

Also, how do I find an ARF specialist???

That is typically a reference from your pediatrician -- they'll know folks who specialize in Acute Rheumatic Fever -- typically a rheumatologist.

 

Buster

Thanks Buster! I searched again and found a very informative article on ARF at wikidoc, which mentioned PANDAS.

http://wikidoc.org/index.php/Rheumatic_heart_disease

 

So I thought I would search for PANDAS on the same site. What came up is the usual "controversial diagnosis" and "experimental treatment" thing...

Apparently, anyone can edit this, but I don't feel qualified. Maybe you or some other eloquent person would like to go in and edit this so at least if some unfortunate parent out there runs into this site they'll have a better picture?

http://wikidoc.org/index.php/PANDAS

[AmySLP]

I have been worried about RF. I had a long conversation with a nurse last night at work about how I plan to call the cardiologist today. Last year when we saw Dr. Latimer she got us an immediate appt with a cardiology colleague of hers to look at Allison b/c during the summer of 2008 her strep was misdiagnosis for about 6 weeks. The cardiologist ruled out any cardiac damage from the strep. I was thinking shouldn't we compare a new diagnostic cardio test with last years to be sure. My mom suspicions are that my daughter has had this strep for a while and that it has been a symptomatic with the exception a few few isolated fevers that were coming and going over the last 2 months. Her kindergarten classroom has 25% of the kids dx with strep since late Dec/early Jan with recurrence in 2 of kids. The school nurse called me about a month ago to ask me if I had Allison tested for strep-I called the ped. who did not think it was warranted without symptoms, even though I really wondered about that decision.

 

Last p.m. and this a.m. my daughters "hives" look more like large reddened areas. They are less itchy, covering her face, head and neck AGAIN and diffusely throughout her body. They are less raised like hives and now I don not see the distictive fluid filled center of hives. I have been looking at pictures of the rash that comes with RF/scarlet fever and it does resemble it. I wondered if I should call a local dermatologist/immunogist that my other daughter has seen to see if she would take a look at her today. I will definitely be calling the cardiologist, but he's in the V.A./ Washington DC area-hoping he can order a test(s) if needed here locally.

 

Thanks for all your information-it's truly what's keeping me going!

 

Amy

[JAG10]

Amy,

 

I'm thinking of you. Your daughter is so fortunate to have such an on-the-ball mom!! Sending positive vibes your way.

 

Jill

[thereishope]

I am so sorry! This is when depression and anxiety sets in for the parents as well. Let's all pray that the near year of no strep has healed her enough that she will not have a major setback If she can take Ibuprofen, I would probably start giving that for the next week to fend off any inflammation that may occur.

 

You and your family will be in my thoughts and prayers.