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Impetigo causing exacerbation in 2 and 5 year olds?

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Maybe I should break this up into two posts, but I don't want to "hog" the forum. Two questions:

 

Both kids have pandas (ages 5 and 2). My 2 year old has been battling impetigo for about 5 months now. He is on his 3rd antibiotic(Septra) and also a steroid burst. The first 2 antibiotics, while they helped the pandas symptoms tremendously, did not altogether get rid of the impetigo (Keflex and augmentin). So my question is, what do you all think is causing the impetigo, strep or staph? I should add here that my 5 year old cultured positive for staph in his THROAT during this time, and also I developed an absess in my finger that cleared up with a round of antibiotics. We have been assuming this whole time that the impetigo is staph due to my 5 year olds' culture, but then the pediatrician said that MOST impetigo in children this young is due to strep. Also, how likely is it that the impetigo is causing my 5 year old to exacerbate with pandas symptoms, regardless of what microbe we are dealing with?

 

Also, I just started my 2 year old on his first steroid burst (hard to differentiate pandas vs. being 2, so I have been waiting for a DEFINITE pandas exacerbation and I think today I got one - like out of exorcist movie). The thing I did not expect is to see results within 12 hours of his first dose! I mean, he is still a little crabby and may still have a tic, but he started speaking a bunch of words (he is speech delayed) and he started giving me tons of affection today. Also, his impetigo looked SO MUCH better and his eczema looked much better. All within 12 hours. Is that possible?

 

Unlike in my 5 year old, I have not quite gotten his tell-tale pandas symptoms defined. Being non-verbal it is hard to pick up on OCD. The one thing that stands out sometimes is his eye tics. But when those are absent, I don't really know what I am looking for!! I do know that today he had a very crazed look in his eyes while he went nuts and he didn't know what he wanted. He kept pointing to things and screaming his head off. He was so lost and confused and crazed! I finally gave him ibuprofen and within 20 minutes he was very calm...so I started the steroid that I have had in my fridge for just such an episode.

 

Stephanie

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Stephanie-

 

My younger daughter definately responds to the steroids after the first or second dose. For her, by day 4, she usually has a remission from almost all symptoms. That IS faster than most kids- but it does happen.

 

Hope this is the start of healing...

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Our worst episode ever was exposure to impetigo - at our best guess. We saw no other reasons, and she did not get sick herself, but within 2 days of a sleepover with a child that had active impetigo, our dd's OCD was severe. We also saw an immediate response to Prednisone.

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Just wanted to add that if someone is exposed to impetigo they can get strep throat and if someone is exposed to strep throat, they can get impetigo. When my daughter was younger she used to get impetigo when she had strep. Impetigo can be caused by staph, but my bet is with PANDAS children it is almost always caused by strep.

Colleen

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Our son's PANDAS dx was related to impetigo - that's the only type of strep infection either of my kids have ever had. He was just about to turn 2 when the switch was flipped. Like you - we thought he was just being 2, terrible 2 to be specific. But as the rages continued and got worse, we realized something was wrong. It is hard to differntiate when they're that young, but we've noticed that our little guy has a distinct body language when he's having an "episode". He gets a posture about him, and a look in his eye/facial expression that's not normal for him and that clues us in that something is off. He's been on zith for almost 3 months now, with some significant improvement. We were about 80% back until his best friend got strep a week or so ago - now we've been having some bad days the likes we haven't seen in months!

 

I can't speak to the steroids, because my son hasn't had to take them at this point - the azith is working - albeit slowly. But it's slow and steady, which is par for the course!

 

I hope he continues to get better!

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Stephanie,

My PANDAS ds definitely reacted when his sister had impetigo. It was all over her face and it cleared pretty quickly with the antibiotic cream (I think it was Muporicin or something like that?). Did the pediatrician give you any other options as to how to clear the impetigo? 5 months seems a very long time! Also, are you disinfecting the house properly? They could just be picking it back up. I know it's a pain, but either staph or strep can be hard to erradicate. The infectious disease specialist we saw suggested giving the kids baths with 1/4 cup bleach everyday for a couple of weeks, and then after that maybe twice a week. During the first week, make sure you launder all linens in the hot cycle, and take care of bathrooms, switches, doorknobs, etc. This is what they do for resistant staph infections. I am not saying you need to do this precisely, just suggesting oral antibiotics alone may not be enough. I have not done this yet, but I think I will once the weather gets a little nicer and their skin is not so dry. Last time we had an "outbreak" I even bleached all the stuffed animals! I have to say we did stay clear for a while...

Also, have their tonsils looked at (if they still have them!)

 

Isabel

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My 3 y/o had a stubborn case of impetigo, that I believe led to my PANDAS daughter being dx with strep. The doc recommended a topical made specifically for impetigo- I believe it was Alabax. It was pricey but did clear the spot.

 

 

amy

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Altabax is what our Dr also prescribed for our impetigo breakouts and it always cleared it up quickly. As a matter of fact, when my son was first dx PANDAS, along with the azith that he prescribed, he also had us apply Altabax to the mucous membranes inside his nostrils for a few weeks. Apparently strep bacteria can hang out there and it won't be cleared up by the oral abx alone.

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Thank you for all of your replies! My sons ped said that most kids this age (2) get impetigo from strep, however, my 5 year old got a positive throat culture for staph during this time. So we are assuming it is staph (but with my luck it is both strep and staph!). Either way, I assume it can exacerbate both kid's pandas.

 

We started with Mupirocin cream, then we were switched to Altabax b/c it has less resistance. We are just finishing up the 3rd antibiotic and the impetigo seems clear for now. I am definitely going to do some laundry (hot) tonight and disinfect the house so that he does not become reinfected. I have not been able to bring myself to do the bleach baths, as he has very bad eczema at times. But I am using a medicinal soap that has an antibiotic in it.

 

By the way, my 5 year old just received a stool analysis that showed 1+ for staph aureus. The lab indicates that this is "non-pathogenic", does anyone know if this would pose as a problem? Do we all have staph in our guts??? He also had klebsiella, but that's another post. We are the "house of microbes"!!!!!

 

Stephanie

 

 

 

Altabax is what our Dr also prescribed for our impetigo breakouts and it always cleared it up quickly. As a matter of fact, when my son was first dx PANDAS, along with the azith that he prescribed, he also had us apply Altabax to the mucous membranes inside his nostrils for a few weeks. Apparently strep bacteria can hang out there and it won't be cleared up by the oral abx alone.

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I have not been able to bring myself to do the bleach baths, as he has very bad eczema at times. But I am using a medicinal soap that has an antibiotic in it.

Stephanie,

 

I know what you mean, I haven't done it either... We also see eczema every now and then. Just keep in mind it is very important to keep the skin in good shape as chapped skin or cuts can be an open door to infection. We've been using Gold Bond lotion and it works great.

What is the soap you use?

 

Isabel

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Thanks for the gold bond tip. I use "Hibiclens" soap for my 2 year old.

 

Stephanie

 

I have not been able to bring myself to do the bleach baths, as he has very bad eczema at times. But I am using a medicinal soap that has an antibiotic in it.

Stephanie,

 

I know what you mean, I haven't done it either... We also see eczema every now and then. Just keep in mind it is very important to keep the skin in good shape as chapped skin or cuts can be an open door to infection. We've been using Gold Bond lotion and it works great.

What is the soap you use?

 

Isabel

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Maybe I should break this up into two posts, but I don't want to "hog" the forum. Two questions:

 

Both kids have pandas (ages 5 and 2). My 2 year old has been battling impetigo for about 5 months now. He is on his 3rd antibiotic(Septra) and also a steroid burst. The first 2 antibiotics, while they helped the pandas symptoms tremendously, did not altogether get rid of the impetigo (Keflex and augmentin). So my question is, what do you all think is causing the impetigo, strep or staph? I should add here that my 5 year old cultured positive for staph in his THROAT during this time, and also I developed an absess in my finger that cleared up with a round of antibiotics. We have been assuming this whole time that the impetigo is staph due to my 5 year olds' culture, but then the pediatrician said that MOST impetigo in children this young is due to strep. Also, how likely is it that the impetigo is causing my 5 year old to exacerbate with pandas symptoms, regardless of what microbe we are dealing with?

 

Also, I just started my 2 year old on his first steroid burst (hard to differentiate pandas vs. being 2, so I have been waiting for a DEFINITE pandas exacerbation and I think today I got one - like out of exorcist movie). The thing I did not expect is to see results within 12 hours of his first dose! I mean, he is still a little crabby and may still have a tic, but he started speaking a bunch of words (he is speech delayed) and he started giving me tons of affection today. Also, his impetigo looked SO MUCH better and his eczema looked much better. All within 12 hours. Is that possible?

 

Unlike in my 5 year old, I have not quite gotten his tell-tale pandas symptoms defined. Being non-verbal it is hard to pick up on OCD. The one thing that stands out sometimes is his eye tics. But when those are absent, I don't really know what I am looking for!! I do know that today he had a very crazed look in his eyes while he went nuts and he didn't know what he wanted. He kept pointing to things and screaming his head off. He was so lost and confused and crazed! I finally gave him ibuprofen and within 20 minutes he was very calm...so I started the steroid that I have had in my fridge for just such an episode.

 

Stephanie

 

I have been dealing with PANDAS with my older son since he was 3 (he is 8 now), however we did not know exactly what we were dealing with until he was 4. What is crazy about your post is that I have never seen anyone say anything about Impetigo and Pandas. I use to always be on this forum and after we gave up and put my oldest on antibotics perminatly (been 3.5 years), unless there is an outbreak, i don't go on here much.

 

anyway, after 3 months with crazy behaviour with my 4 yr old son, depression, anger, crazy mood swings etc. He also kept an ear infection, sinus infection, you name it.. suddenly he started the having to pee every 20 minutes and clingy. We took him back to the doc yesturday for yet a different antibotic adn what do I hear.... He could have STREP in his ears and it maybe be something called PANDAS! I thought I would die, but it all makes sense, he has joint pain, etc.

 

Ok, back to my story about the impetigo. When 2nd son was a baby he got impetigo and at the same time my older one (then 4) got a raging case of the eye tic and ADHD symptoms, it was horrible. I kept taking the younger one in saying it had to be Step, that the other one was reacting to it.. and they blew me off. We finally got rid of it, it went away, then came back and the same thing again. I always thought there was a connection, but no one would listen.

 

So, the story thickens, in the last 4 months my older one has had his tic come back some and had some behaviour problems so I doubled his meds. All his throat cultures were negitive, I could not figure out what was triggering it. During this time, my younger one was having the sudden behaviour problems, I thought I had the devil on my hands.. angry morning and night, then suddenly sad. He was also fighting ear problems, etc since January.

 

So, 10 days ago, I was so worried about my younger one, I forgot to give my older one 2 pills of antibotic a day, only one (this usually would start a tic back). And my younger one was getting treated with Omnisef... my older one cleared up.. no tic!

 

So I wonder if (like at your house) my younger has been triggering my older one the whole time?? What in the world?

 

They have a cousin (4) we think also has this..

 

I am now convinced that when he was a baby and had impetigo, it was Strep. No dout.

 

So frustrating having 2 in the house with PANDAS problems and their symptoms seem to be so different.

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Yes, it really is a vicious cycle when you have two, and wow is it overwhelming when they both go into an exacerbation at the same time! I don't know about you, but both of my kids really lose it. One falls to the floor crying and I have to pick him up and carry him and hold him like a baby (this is my 5 yo). The other one goes into a psychotic rage and throws toys and hits me and at the same time looks very confused about what he wants and why he feels this way (2 yo). They are both such sweet happy kids when not in exacerbation so it is just so intense.

 

It is so hard keeping thier germs separated...let's face it - impossible. I have tried! I even tried keeping them out of school for a couple months but they still got sick just as often and gave it to each other. So, I have them both on prophylactic abx but it is just not enough at this point. I recently started spironolactone for both (you can see my other recent post about this) and it has really helped alot, but I still can't get on top of the darn impetigo! I may go see an infectious disease doc soon.

 

Stephanie

 

 

Maybe I should break this up into two posts, but I don't want to "hog" the forum. Two questions:

 

Both kids have pandas (ages 5 and 2). My 2 year old has been battling impetigo for about 5 months now. He is on his 3rd antibiotic(Septra) and also a steroid burst. The first 2 antibiotics, while they helped the pandas symptoms tremendously, did not altogether get rid of the impetigo (Keflex and augmentin). So my question is, what do you all think is causing the impetigo, strep or staph? I should add here that my 5 year old cultured positive for staph in his THROAT during this time, and also I developed an absess in my finger that cleared up with a round of antibiotics. We have been assuming this whole time that the impetigo is staph due to my 5 year olds' culture, but then the pediatrician said that MOST impetigo in children this young is due to strep. Also, how likely is it that the impetigo is causing my 5 year old to exacerbate with pandas symptoms, regardless of what microbe we are dealing with?

 

Also, I just started my 2 year old on his first steroid burst (hard to differentiate pandas vs. being 2, so I have been waiting for a DEFINITE pandas exacerbation and I think today I got one - like out of exorcist movie). The thing I did not expect is to see results within 12 hours of his first dose! I mean, he is still a little crabby and may still have a tic, but he started speaking a bunch of words (he is speech delayed) and he started giving me tons of affection today. Also, his impetigo looked SO MUCH better and his eczema looked much better. All within 12 hours. Is that possible?

 

Unlike in my 5 year old, I have not quite gotten his tell-tale pandas symptoms defined. Being non-verbal it is hard to pick up on OCD. The one thing that stands out sometimes is his eye tics. But when those are absent, I don't really know what I am looking for!! I do know that today he had a very crazed look in his eyes while he went nuts and he didn't know what he wanted. He kept pointing to things and screaming his head off. He was so lost and confused and crazed! I finally gave him ibuprofen and within 20 minutes he was very calm...so I started the steroid that I have had in my fridge for just such an episode.

 

Stephanie

 

I have been dealing with PANDAS with my older son since he was 3 (he is 8 now), however we did not know exactly what we were dealing with until he was 4. What is crazy about your post is that I have never seen anyone say anything about Impetigo and Pandas. I use to always be on this forum and after we gave up and put my oldest on antibotics perminatly (been 3.5 years), unless there is an outbreak, i don't go on here much.

 

anyway, after 3 months with crazy behaviour with my 4 yr old son, depression, anger, crazy mood swings etc. He also kept an ear infection, sinus infection, you name it.. suddenly he started the having to pee every 20 minutes and clingy. We took him back to the doc yesturday for yet a different antibotic adn what do I hear.... He could have STREP in his ears and it maybe be something called PANDAS! I thought I would die, but it all makes sense, he has joint pain, etc.

 

Ok, back to my story about the impetigo. When 2nd son was a baby he got impetigo and at the same time my older one (then 4) got a raging case of the eye tic and ADHD symptoms, it was horrible. I kept taking the younger one in saying it had to be Step, that the other one was reacting to it.. and they blew me off. We finally got rid of it, it went away, then came back and the same thing again. I always thought there was a connection, but no one would listen.

 

So, the story thickens, in the last 4 months my older one has had his tic come back some and had some behaviour problems so I doubled his meds. All his throat cultures were negitive, I could not figure out what was triggering it. During this time, my younger one was having the sudden behaviour problems, I thought I had the devil on my hands.. angry morning and night, then suddenly sad. He was also fighting ear problems, etc since January.

 

So, 10 days ago, I was so worried about my younger one, I forgot to give my older one 2 pills of antibotic a day, only one (this usually would start a tic back). And my younger one was getting treated with Omnisef... my older one cleared up.. no tic!

 

So I wonder if (like at your house) my younger has been triggering my older one the whole time?? What in the world?

 

They have a cousin (4) we think also has this..

 

I am now convinced that when he was a baby and had impetigo, it was Strep. No dout.

 

So frustrating having 2 in the house with PANDAS problems and their symptoms seem to be so different.

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  • Help us learn if blood type has a correlation with PANDAS/PANS   78 members have voted

    1. 1. If you are the biological mother of a child diagnosed with PANDAS or PANS (or you believe the child has PANDAS or PANS), please select your blood type below:


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      • A -
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      • AB -
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