Questions about strep and recovery

[Anonymous]

My dd gets frequent cases of strep. This winter, she got strep, then 2 days later, came down with strep symptoms again. In this case, it seems like the first case probably wasn't cleared up. After the 2nd case of strep, she was well for 2 weeks, then she got strep again this Sunday. Here are my questions.

1. When she gets sick with strep, the dr always says she can go to school after being on medicine for 24 hours. However, she is always too sick to go bad that soon. It usually take her a full week of staying at home to feel up to going back to school or her extracurriculars. Is this normal? Is there anything I can do about it?
2. Why does she get strep so often?
3. Should I look into getting her tonsils out.

In first grade, she got strep 7 times. In second grade, I think she got strep 3 or 4 times. This year in 3rd grade, she is either on case 2 if you think of the first case as one long extended case. Oh and before public school, she did attend preschool for 3 years. She did not get strep this frequently in preschool though. However, I remember her first case of strep was on her first birthday.

[Anonymous]

There are a few issues here. I think it takes longer than 24 hours to bounce back from strep. It can take up to 72 hours (or more) to feel well enough to go back to school. It totally depends on the kid and the case of strep, however. Sometimes 24 hours is fine. But strep can be very painful and debilitating, especially if there's vomiting.

Strep is not usually a tonsil issue, but I'm not that conversant.

If your child is having strep 7 times a year, I would see an ENT. There may be an issue of being a strep carrier, or she may need a different/stronger antibiotic. I know I carried strep for about 3 years and had it almost constantly. Finally got rid of it.

[Anonymous]

The doctor says she can go back to school because she's not contagious after 24 hours on antibiotics. But that doesn't mean she is up for it. A week does sound a bit long to be out. Whenever I've had it or my kids had it, we're back to school after 3 or 4 days. No one is 100%, but definitely up for school.

Are you saying she has a fever all those days? Is she sleeping most of those days she's home?

[Anonymous]

After the first 4-5 days on antibiotics make sure you...

-toss her toothbrush and toothpaste
-sterilize any water bottles she uses (if she uses a non-spill one like camelback or Contigo, just throw it away, you will never get small the bacteria out)
- sterilize anything else that goes into her mouth. (Instruments, etc)
- wash bedding on hot

Our ds got strep 8 times one year. It would recur every time he stopped antibiotics until we threw all of his water bottles out and bought new ones. Sterilizing just wasn't getting everything.

[Anonymous]

Do you always use the same antobiotic? Perhaps it's not working.

[Anonymous]

You could consider a tonsillectomy. I'd do a consult with Dr. Earl Harley, ENT at Georgetown.

[Anonymous]

I don't know what exactly it has to do with the tonsils, but a friend of mine whose DD had frequent cases of strep had her tonsils removed. No more strep. Maybe the bacterial hides in some people's easier than others?

[Anonymous]

Anonymous wrote:I don't know what exactly it has to do with the tonsils, but a friend of mine whose DD had frequent cases of strep had her tonsils removed. No more strep. Maybe the bacterial hides in some people's easier than others?

Yes--definitely strep can hide in the tonsils (and adenoids) and cause recurring symptoms.

[Anonymous]

Anonymous wrote:Do you always use the same antobiotic? Perhaps it's not working.

The first case of strep, she had amoxicillin. The second case, she had cephalexin. This time, she is on augmentin which is absolutely horrible because it tastes so bad. She is only on the 6th dose out of 20. It is a struggle every single time to get it down her. I let her sleep in today, and then took her to school late. She said she felt ok to go to school, but that she didn't want to go to school. She even cried when I left, but the teacher emailed me and said she was doing ok. I wish I had the option of not working, but I have a lot of deadlines at work, and my dh just started his new job 2 weeks ago. Ugh.

[Anonymous]

Yes you should have her tonsils out. Research PANDA. I know of several people who got this from frequent strep throat infections.

[Anonymous]

PP here - It's actually PANDAS
http://www.nimh.nih.gov/health/publications/pandas/index.shtml

[Anonymous]

PANDAS mom here. Nothing OP has reported sounds like PANDAS--you see definite behavioral changes, tics, OCD, or phobias etc with that.

That said, Dr. Harley, named above, does have experience dealing with PANDAS kids.

[Anonymous]

She is a carrier.

My sister got strep maybe 10-12 times per year (and was CERTAINLY contagious when not on antibiotics -- she gave it to me and my siblings almost every time she showed symptoms).

Then, she got a tonsillectomy and literally NEVER GOT STREP AGAIN. However, we all have issues from being on antibiotics dozens of times as children.

Definitely, definitely look into a tonsillectomy.

[Anonymous]

How are you discovering the repeat infections, especially if it is only days later? Is she becoming symptomatic again, or are you going in for a throat swab to confirm the indection cleared, only to discover she still has strep? Is it possible she's a carrier and will always show as strep positive?

[Anonymous]

Anonymous wrote:How are you discovering the repeat infections, especially if it is only days later? Is she becoming symptomatic again, or are you going in for a throat swab to confirm the indection cleared, only to discover she still has strep? Is it possible she's a carrier and will always show as strep positive?

This is OP, she is becoming symptomatic again. That is how we are finding out about each new case. This Sunday, she said she didn't feel well and had no fever, but an hour later, her fever was 102. I gave her tylenol, and her fever was still 102. Urgent care gave her motrin, and her fever was still 102. She finally started getting better after a dosage of augmentin. There are times she is sick, and we have taken her in for a strep test, and the strep test has been negative both the short and long tests, so she is not 100% positive for strep. I do think that we will schedule with an ENT and look into getting her tonsils out. Most of my step brothers and sisters had to have that done, but I don't know of any of my blood relatives that have had to do that. I will have to ask my family. A tonsillectomy sounds a bit scary, but is starting to make sense.

I don't think she has PANDAS. I have read up on that quite a bit, and she has no tics of any kind. She is a bit anxious at times and has ADHD, but no sudden onset of tics. Her not wanting to go to school is nothing new.