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Respiratory Disorders (Expert Forum)
recurring strep throat in our family
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recurring strep throat in our family
by karenmcg, Aug 06, 2005 12:00AM
In the last 3 months, my daughter has had strep throat 4 times, and I have had it 3 times, all 7 cases confirmed by positive throat cultures. My daughter has taken penicilin the first 3 times, then the fourth time both Clindamycin and Rifampin (the latter given the last 4 days of the former). Our entire family of 4 was tested to see if any of us are carriers, with negative results. My tonsils were removed as a child, yet there is talk of removing my daughters (seems pointless to me). None of the doctors we've seen have any other ideas. I'm thinking of giving us both Colloidal Silver. We take vitamins, probiotics & adicophilus, we never share drinks, we've changed the toothbrushes every time (sometimes twice), we wash our hands often, and we are both otherwise healthy (no known allergies). We've never been aware of being exosed to anyone else with strep. I fear the bad effects of all the antibiotics, and we're just sick of being sick! Please help!
Doctor's Answer
by National Jewish, Aug 28, 2005 12:00AM
, Aug 28, 2005 12:00AM
There are several possibilities. Despite the lack of evidence, you could have a partially resistant variety of Strep type A. Even though you are feeling better after taking the antibiotics, the infection is never completely clearing. The fact that you and your daughter have had a total of 7 episodes strongly suggests that you may be re-infecting each other. The cultures for carrier status may not have been appropriately timed to detect the strep. Also it’s possible that a non-family carrier -- friend, playmate, classmate, neighbor or teacher -- may be infecting both you and your daughter.
You should consult with an infectious disease specialist before any consideration is given to your daughter having a tonsillectomy.
You should consult with an infectious disease specialist before any consideration is given to your daughter having a tonsillectomy.
Pets can carry strep. Try culturing your dog if you have one. Your vet can do this for you.
http://www.healthypet.com/faq_view.aspx?ID=22&sid=1
Does anyone have impetigo? Check out this site:
http://tinyurl.com/9hknd
This is an excellent article:
http://www.emedicine.com/ped/topic2702.htm
"Children with untreated acute infections spread organisms by airborne salivary droplet and nasal discharge. The incubation period for pharyngitis is 2-5 days. Children are usually not infectious within 24 hours after appropriate antibiotic therapy has been started, an observation that has important implications for return to the daycare or school environment. Individuals who are streptococcal carriers (chronic asymptomatic pharyngeal and nasopharyngeal colonization) are not usually at risk of spreading disease to others because of the generally small reservoir of often-avirulent organisms. Fingernails and the perianal region can harbor streptococci and play a role in disseminating impetigo. Multiple streptococcal infections in the same family are common. Both impetigo and pharyngitis are more likely to occur among children living in crowded homes and in poor hygienic conditions."
Pay particular attention to your child's hygiene - handwashing and bathroom hygiene. Perhaps this may be playing a role. Fingernails should be short and clean. Kids are just not very attentive with this stuff, especially at early school age, so parents have to make sure. My daughter used to just wet her toothbrush and tell me she brushed her teeth when she was in second or third grade. She's 25 now and has no idea why she did this back then; she just did.
The sequelae of untreated Group A beta strep are acute rheumatic fever and acute glomerulonephritis, so you can't NOT treat this organism.
From the same article - an interesting paragraph:
"Sometimes families express concern regarding the delay of 24-48 hours that is required to obtain a result of throat culture. Clinicians therefore feel pressure to initiate therapy immediately, prior to obtaining the result of the culture. However, because treatment of group A streptococcal sore throat as long as 9 days after onset of symptoms still effectively prevents rheumatic fever, initiation of antibiotics is seldom of urgent importance. Early antibiotic therapy may have beneficial effects in relieving symptoms and allowing an earlier return to school or daycare; however, early antibiotic therapy may have disadvantages as well. Several controlled studies have shown that children receiving immediate antibiotic therapy are more likely to have symptomatic recurrences in the months following treatment than are children who delay the initiation of therapy by 48 hours."
Hope this gives you some ideas.
I can't really comment on waiting a couple of days as I'm NOT a doctor. I only pointed out the article as I thought it was interesting.
What does your pediatrician say about all of this?
This is a page from www.quackwatch.com on Colloidal silver. Please read this and then decide if you want to take this very dubious substance.
If you believe that the vapor kills strep I have a bridge in Brooklyn I'll sell you cheap.....
I'm a clinical microbiologist with nearly 30 years experience. Strep cultures are not 100% capable of recovering the strep. Rapid tests are not 100% accurate. Have you been growing Group A beta strep or another group like Group C? Group A is the one that can have lasting consequences such as rheumatic fever and kidney side effects, but other streps can also cause sore throats, particularly group C.
Labs differ in the ways that they culture strep screens. Some methods are better than others. Just because you had a negative culture doesn't necessarily mean that you didn't have it - there's always sampling error (did you gag real good when they took the specimen?). If the organism was there in really low numbers the swab may not have picked it up. A combination of rapid strep testing and culturing of negative rapid tests is the best way to cover all your bases. If you're only having rapid testing done, without a culture backup (actually having a lab plate the swab on an agar plate and looking for the beta strep), this can miss other groups of strep, as the rapid test only picks up Group A.
Hope this helps.