Chronic Strep?

[Jolie, BSN]

For the second winter in a row, my 5 year old has had multiple bouts with strep throat. In October, she was very ill with a high fever, sore throat which was beefy red with white patches, headache, vomiting, and rash. She was treated with Amoxicillin for 10 days.

Over the last month, she has had 4 episodes of vague, non-specific viral-like symptoms such as a headache, and tummy ache. Each episode has been accompanied by a low-grade temp lasting about 2 days. I checked her throat each time, and it never looked remarkable, nor did she complain of a sore throat.

Yesterday, after missing her 13th day of school, I took her to the ped, even though I was convinced that she had a viral illness. The nurse did a rapid strep, which I thought was overkill, but I said OK anyway. It was clearly positive, and my daughter is back on Amoxicillin.

My question is this: Does this sound like chronic colonization with strep? It concerns me that she has this without appearing to be very sick, and makes me wonder how many episodes of strep I have missed by chalking them up to a virus.

Should I request a culture when she finishes her current course of antibiotics? If she tests positive again this winter should I ask for a C&S? If she is a chronic carrier, what is the course of action?

I know I should have asked these questions yesterday, but my brain is usually about 10 minutes behind the times! Thanks.

[live4today, RN]

If it were my child in this situation, I certainly wouldn't let it rest until more is done and explained.

Sounds to me like you should go back and sit down with the pedi doc for a conference regarding this matter. If he/she doesn't have time to sit down and answer your questions regarding your daughter's illness...find a new doc.

[LisaRN2B]

At the risk of telling you something you may already know, I will ask: Do you have cats? Cats are carriers of strep.

That said, my son has also had recurrent bouts of strep throat recently. I will be interested to find out any info anyone else has about this.

[Jolie, BSN]

I didn't know that about cats. But no, we are a dog family!

[LisaRN2B]

Originally posted by Jolie

I didn't know that about cats. But no, we are a dog family!

We don't have cats either, but I have been asked that over the years when my other children have had strep, whether we did.

My son has been on two courses of antibiotics and is also presenting viral like symptoms and sore throat. It is making me wonder, as the strep tests keep coming back positive, if this is a strain resistant to the antibiotics? Scary, if that is the case.

I, too, am hoping someone may have some sage advice in this situation.

[BarbPick]

I can only speak about my own childhood expereince. I had chronic sore throats and at age 14 they removed my tonsils.

About the culture after, From what I remember about microbiology, once treated, you might have a false negative. Kinda like doing a blood culture after antibiotics have started. Might want to wait a week or two after the antibiotics have finished.

[time4mydream]

hi. when my daughter was 8 she had about 6 bouts of strep in a 6 month period. this followed the previous winter of a few bouts of strep too. i believe her tonsils were carrying the strep bacteria. the doctor would start her out on amoxicillin and it did not touch the strep at all. when she gave her something stronger it would take care of it. she even had strep at the same time she had the chicken pox. she was miserable. my daughter always had what i called her "classic strep symptoms". if she complained of a headache, stomachache and had a fever with her sore throat, she would have strep. i even named her breath, "strep breath". she would also test positive for strep without having any signs at all. i still remember the time that i took her to the doctor because i wanted her checked for strep because i thought she had it and the nurse sort of laughed at me saying she did not have strep and sure enough she was positive. finally, i took her to an ENT who went ahead and removed her tonsils. it has been 9 years since then and she has never had another case of strep. i know that they frown on removing tonsils, but in a situation like my daughters, i could not see any reason for leaving her ugly tonsils in her throat anymore.

if your daughter gets strep again, i would make sure to ask for something stronger than amoxicillin. that would be a good place to start.

i hope that this helps. i know i used to hate to see my daughter so sick and miserable time and time again.

[Rapheal]

I went through this with my daughter (no cats at home). She also went and saw an allergy specialists, an ENT. They said she had big tonsils but not a problem. She was on Nasalcron for 2 years. She also kept suffering from temporary hearing loss from fluid build up in her ears, so she saw an audiologist more than once to.

Well when they wanted to keep her on maintenance antibiotics for 9 months I requested that her tonsils come out.

Back to the ENT- he agreed. She had them removed, she gained weight, she grew, she became healthy instead of sickly.

Hope your daughter gets well and stays well real soon. Best wishes. Beth

[kc ccurn]

When I was high school I was always getting step throat, this continued through college and into adult hood.

Finally, my doc told me that if I had strep one more time, out came the tonsils. Of course then, I didn't have strep again for another year and a half. Then it hit again, another bout with strep throat. I went back to my doc and did eventually have my tonsils taken out. It has helped tremendously. I haven't had strep since.

I wish I had had my tonsils out as a kid, it is much more painful as an adult than as a child.

[NRSKarenRN, BSN, RN]

Same Scenerio with my youngest son. Multiple bouts sinusitis, strep throat. Saw ENT at age 13, tonsils and adenoids removed with 50cc pus sitting behind them.

Only one bout of sinus trouble in past 2 years since, alons with allergy shots for many allergies especially NUTS (anaphylaxis).

Hope your sweety better soon.

[KriseeLPN]

just wondering if any of these children w/strep also have tourettes or tics of any sort? There is a correlation between strept and tourettes.

[LisaRN2B]

Originally posted by KriseeLPN

just wondering if any of these children w/strep also have tourettes or tics of any sort? There is a correlation between strept and tourettes.

No tics or tourettes here.