PANDAS / Strep Skin Infection?

[jstone]

Hello. I am relatively new to the group. First, thanks so much for all of the great information. We really feel we hit a sweet spot on this forum.

Our 4 yr old son does not have an official PANDAS diagnosis, but based on his OCD behavior, medical history and some antibodies testing, he is a clear candidate. Anyway, some of his more severe OCD behavior comes and goes. We have been suspecting that those specific and more severe behaviors occur when he is having an active strep infection or going through some kind of strep clearing (we are doing some homeopathic treatments at present). When it is not so severe, well, who knows. Hopefully its some kind of healing, but I also know that those strep buggers can hide, go dormant, or the immune system is simply not doing its job because of autoimmune issues. Anyway, on this past Friday, the more severe OCD started. We noticed that he also was getting a large pimple looking growth on his tummy. It looked like a bite because it got so big, but today after his FIR Sauna, it grew a head. Well, we couldn't help ourselves, and we popped it. A large amount of puss came out (about a 1/2 Tsp). it was yellow and light brown. My question is in two parts: 1) could this be strep? and 2) we saved the puss on the kleenex and so does anyone know of a test we can do on the puss and do we freeze it or just keep it at room temp in the meantime?. BTW, the last time he had these severe OCD behaviors, he got a similar 'pimple' on his finger. Could the strep be manifesting itself through his skin. And if so, how does this relate to the strep that we all agree is infecting the PANDAS kids' basal ganglia or at least cross reacting with the good neorons from an antibody standpoint. Any feedback would be greatly appreciated!

[airial95]

I don't know about testing the puss, but our sons PANDAS was triggered by impetigo (strep infection of the skin) and it looks just like a bad pimple or bug bite. With his infection that triggered the PANDAS we originally thought it was a bug bite as well, but ultimately took him to the doc when it got so swollen and found out about the strep. My sons major symptoms are OCD and ODD. Usually about 2-3 days before someone presents with strep, we see a jump in the ODD and an increase in the severity of his rituals.

 

So in a nutshell - yes, impetigo can bring on symptoms!

[forjpj]

Yeah my son gets impetigo and it sets him off. He is 3 1/2 months post pex and he was back to 95% but an impetigo infection set him back to 75%. Not too terrible, but not as good as he was. It was interesting though...we had never had the sudden onset, but with this latest infection I think I got a taste of the sudden onset. He had been fine all morning, and then all of a sudden he started screaming.

[matis_mom]

Hi there,

I am not sure what it may be, as impetigo for us looked more like a rash (not a single, isolated pimple), but I think you are right in trying to see exactly what it is. If you have a good, open-minded pediatrician, they could culture it for you. Other than that, I suppose you could buy the rapid strep test kit (through Amazon), and try doing it at home. It could be staph or strep, I don't know if you can get a staph kit.

Try do journal and document all this, as it may be very helpful in the future if you are trying to get a diagnosis/treatment for your son.

[Kayanne]

I don't know about a sample that you give to the dr on a tissue, but my childrens' pediatrician has done rapid strep tests on skin infections before, he just tries to get a decent swab of the infected area. My kids have had impetigo three times (before we ever heard of PANDAS)...each time they looked like small pimples, they itched, and they seem to spread quickly. All of those times, the drs just diagnosed by looking.

[kim]

Jstone,

 

I agree that it could be staph or strep and a culture would be a good idea. They can still culture the spot even if it looks relatively healed. My son had one that he popped and I was astounded that the spot was barely visable by the next day when I got him to the Dr. Staph is really contageous so be certain that you don't share any towels and protect other family members from anything that comes in contact with your son. Keep others off of his sheets etc. until treated. I guess I'm harping on staph because that's what my son had in the way of a skin infection. He had just had minor surgery and the staph was at the surgery site so MRSA was a concern. I don't think your Dr. will give you a hard time, if you tell him you would like it cultured.

[jstone]

I have a call into our pedi as of this morning and will see if they can run a test.

This spot on his skin is definitely a single pimple/pustule and is not a rash, so based on what we researched it does not appear to be impetigo. We will ask our pedi as well. It will be interesting to see if, as the infection goes away, his severe OCD behaviors also lessen.

I really appreciate eveyone's responses.

[airial95]

Both my kids have had impetigo several times, and it was always a pimple, sometimes more than one, but it always looked like a pimple instead of a rash

[jstone]

Both my kids have had impetigo several times, and it was always a pimple, sometimes more than one, but it always looked like a pimple instead of a rash

 

 

 

Airial95,

Thank you so much for your response b/c until I read your post, I wasn't sure what form(s) impetigo took other than a rash. Did the pimples pop? Did you happen to have the pustule tested?

[colleenrn]

It could be strep or staph, but it should be cultured, especially given that his OCD is worse. Are you treating him with antibiotics? Imetigo often gets a honey colored crust on it, but even if it does not have that, I would not rule it out.

 

Colleen

[smartyjones]

hi jstone. my ds had a known strep infection at 22 months. pandas symtoms manifested about 2.5 years later. now, i am not sure if he ever kicked that infection - his only symptom was vomiting and the only reason he was tested for strep was b/c his older brother had a positive rapid the day before. older brother, then 4 yo had only one symptom also - white-head like pimples broke out on his face. one morning, he had many pimples that looked like teenage acne. during the day, they went down but never totally away. the next day, he woke up with them again. by the time we went to the dr around noon, they were down. she didn't think it was strep but tested anyway - positive rapid. he had nothing else - acting and feeling totally fine.

[Suzan]

My 8 yr old dd had pimple's with huge pustule's on her legs/inner thighs. They were very painful, itchy and left purple blotches on her legs. The doc's diagnosed it with molluscum. I never felt comfortable with that diagnosis and felt like it might be related to celiac (DH rash) or something else. A few months into the worst of it, she was diagnosed with vaginal strep and eczema. Within 1 month on abx, her skin completely cleared up and has never returned.

 

Good to look into it further. For DH (celiac related rash) they culture the skin next to the eruption for IgA. We decided not to do this since dd was going to go gluten free anyway. If your ds gets more, I would research this rash as well just in case.

 

Susan

[sf_mom]

If you could get it to weep again at the Dr.'s office/hospital/lab, you can have it typed. I have heard MRSA can appear on the skin as a bug bite/spider bite and often gets misdiagnosed as a result.

 

Looks like spider bite:

 

http://mrsainchildren.com/images/mrsa_in_children_.jpg

 

Looks like pimples:

 

http://2.bp.blogspot.com/_M9JRlA_879c/SUH1...8/s400/mrsa.jpg

 

-Wendy

Edited June 8, 2010 by SF Mom

[airial95]

Both my kids have had impetigo several times, and it was always a pimple, sometimes more than one, but it always looked like a pimple instead of a rash

 

 

 

Airial95,

Thank you so much for your response b/c until I read your post, I wasn't sure what form(s) impetigo took other than a rash. Did the pimples pop? Did you happen to have the pustule tested?

 

 

We didn't have them tested. On my daugter they didn't pop, she got it on her face primarily around her mouth and nose. It looked very much like acne, which is odd for a toddler. The bout that spurred my sons PANDAS was a single pimple on his wrist (which is why we suspected a bug bite). His became so large and swollen (like a golf ball under the skin) that we had to put warm compresses on it to eventually make it abcess - it was very gross when it finally did. With all of the breakouts, our dr had us using altabax and no oral abx. It cleared up in a day or two with the altabax.

 

Ironically, when my son was first dx with PANDAS and started his azith, our dr has us applying altabax to his nostrils for 10 days. He said that strep bacteria can hang out in the membranes and it won't be killed by the oral abx. I wonder if that's why impetigo is so common around the nose and mouth too?

[Geethika]

Hope it might be a kind of strepto or styphylo.

 

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