3 weeks ago I woke up with a sore throat and congestion. Oh no. I was sure it was strep because it seems I get it every 4-6 months. Either Strep A or Strep B. I was leaving that day for a week vacation in Maine and hoped it wasn't and didn't do anything about it until I got home. Indeed it was Strep A.
Regular doctor here in NYC put me on Penicillin V with potassium (that's what it reads on the bottle). I have been on Dr. Z's immune system protocol after 9 mos of garlic protocol. LLMD in ME agreed to put me on Flagyl because I have symptoms of parasitic intestinal infection. The constant symptoms the last 3 months have been irregular sleep (like only 3 hours a night), sweats, and lower back ache, with gastric reflux, heart burn.
Friday night after I told my new personal trainer about the back ache, she said i had a lot of tightness in my itb...she put me on my side on the floor, she rolled a plastic tube from my knee up to my hip on the right side (where the back pain seems to be concentrated) and I screamed from the pain. BUT the back ache was practically nonexistent all weekend.
Friday and Saturday I slept better than I have in months (altho with some help, either Ambien or Tylenol PM; but they don't always work). And the back ache was almost gone. Things were looking up yesterday. It was also my last day of penicillin. I was cleaning and doing chores like I haven't in months.
BUT last night I went to bed and 3 hours later I was wide awake. And there was a tingling/electric current around my lower back/girdle. Much involuntary jerking of the left leg.
I finally got up around 7, after tossing and turning for hours. Had some bfast and noticed that the sinuses were stuffy. And my throat is slimy with stuff I can't cough up, altho I try and almost vomit.
I read the post about mold this morning and am wondering since I was home all weekend and it's been a rainy weekend here whether my apartment could be the cause of my problems. How would I know for sure?
And, back to the strep --- what do I do to prevent the strep from coming back again in a few months? Could it be the source of last night's and this morning's problems? I took my final penicillin last night with dinner, so it's really too soon for hangover strep to be causing these symptoms. I still have 3 days of Flagyll to take.
If my apt is moldy, could it be the cause of the constant strep infections?
Sorry for the rambling nature of this post, but I'm trying to bring all these things together into a logical connection, but maybe there just isn't one.
Any suggestions would be appreciated - I'm supposed to be leaving on a 2 week bicycle trip in Crete in 3 weeks (I booked during a period of very good anti-inflammatories, which made me nauseated with extended use, so I went off them) and now i'm nervous.
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Dr. Mattman stated that if streptococcus is present, it must be treated first before the Lyme is treated because Borrelia feeds on strep. In other words, the strep stimulates the growth of Borrelia. Furthermore, it is impossible to culture Borrelia whenever strep is present because strep is a faster growing bacterium and it will overgrow the culture medium as a 'contaminate', obscuring the presence of Borrelia.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
you said, "Had some bfast and noticed that the sinuses were stuffy. And my throat is slimy with stuff I can't cough up, altho I try and almost vomit.
I read the post about mold this morning and am wondering since I was home all weekend and it's been a rainy weekend here whether my apartment could be the cause of my problems. How would I know for sure?"
Did you have dairy as part of your breakfast?
<< It can cause the slimy throat.>>
How's your diet? Do you follow the no sugar, low carb, anti-yeast diet? << You could have thrush.>>
As for your other question: Mold is a tough one.....I have no clue.
and yes, if you're around pets alot, have them checked for strep...I've heard that too.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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treepatrol
Honored Contributor (10K+ posts)
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posted
quote:Originally posted by Lyme ED: That's interesting Tree, I hadn't heard that explanation before.
Dan, do you have any pets? Just a thought, but I think I read somewhere that you can get strep from your dog, and that some people keep getting reinfected until their dog gets treated.
Yes I have heard that too.
No pets anymore just my wife
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Case Based Pediatrics For Medical Students and Residents Department of Pediatrics, University of Hawaii John A. Burns School of Medicine Chapter VI.34. Lymphadenitis and Lymphangitis Teresa M. Bane-Terakubo, MD June 2003
-------------------------------------------------------------------------------- Return to Table of Contents
A 3 year old female presents to her primary care physician with a chief complaint of a neck mass that has been present and getting worse over 4 days. The mass started as a small lump that has enlarged to the size of a walnut and is now becoming painful, and warm to touch with overlying redness. She has had 2 days of fever up to 104 degrees (40 degrees C). She is also complaining of a runny nose, cough and sore throat for 1 week. Her appetite for solid foods is down but she is drinking fluids well and her urine output is normal. She has not been as active as usual and has not slept well due to the fever. No one at home has been ill but she does attend pre-school and several children have been ill recently with sore throats and URI symptoms. Her history is negative for recent skin infection, skin rash, weight loss, dental problems or cavities, nausea, vomiting or diarrhea. There is no exposure to cats or other animals. Her past medical history, family history and social history are unremarkable.
Exam: VS T 40, P 110, RR 20, BP 80/40, oxygen saturation 100% in room air. Height and weight are at the 50th percentile. She is tired appearing but in no acute distress. Pupils are equal and reactive. Sclera is white and conjunctiva are clear. TMs are normal. Her throat is erythematous with patches of exudate on both tonsils. Some clear nasal mucus is noted within her nares. Her neck is supple with tender bilateral cervical lymphadenopathy. There is a 2 cm x 3 cm tender, warm anterior cervical lymph node on the right with overlying erythema. Fluctuance is present. No axillary or inguinal lymphadenopathy is appreciated. Heart is regular without murmurs. Lungs are clear. Abdomen is nontender and nondistended. No hepatosplenomegaly or masses are noted. Her extremities are warm with full pulses and capillary refill time of one second. No skin rashes or impetigo scars are noted. Neurologic exam is normal.
A throat swab is sent for beta hemolytic strep culture. CBC shows WBC of 25,000 with a left shift. She is started on IV clindamycin empirically. An ultrasound study shows abscess formation. A surgeon is consulted and the abscess is incised and drained (I&D) for a moderate amount of pus. Gram stain shows numerous WBCs and gram positive cocci. Culture of the pus grows out Strep pyogenes (group A strep) within 24 hours. Her throat culture also grows group A strep. Her antibiotics are changed to IV penicillin. She responds to the antibiotics and I&D with dramatic improvement. She is discharged after 3 days of hospitalization to complete a 10 day course of penicillin.
Lymphadenopathy is a common complaint that brings children to see a physician. Fortunately, most of these children will have a benign, self-limited process. However, some children with serious systemic disease or malignancy may present with lymphadenopathy. It is therefore important to understand the differential diagnosis, perform a thorough history and careful physical exam and be aware of the appropriate work up to undertake in a timely manner. Enlargement of a lymph node (lymphadenopathy) may be caused by proliferation or invasion of inflammatory cells (lymphadenitis) or by infiltration of malignant cells. The location of the enlarged lymph node can be helpful in the differential diagnosis. It is normal for healthy children to have palpable lymph nodes in the anterior cervical, axillary and inguinal areas. Palpable lymph nodes in the supraclavicular region; however, often reflect mediastinal malignancy.
Important questions to ask the patient/caregiver include location and duration of the enlarged lynch node (acute vs. chronic, localized vs. generalized), history of prolonged fever, weight loss, arthralgias, skin lesions/infections or rashes, history of recurrent infections, immunization status, contact with sick persons, recent travel, exposure to animals and insects, URI symptoms, sore throat and dental problems/cavities. On physical exam, pay particular attention to location, consistency (solid or fluctuant, smooth or nodular, movable or fixed), number, distribution and size. The appearance of the overlying skin should be noted (red and warm in infection, violaceous coloration in nontuberculous mycobacteria). Hepatosplenomegaly, bruises, petechiae, conjunctivitis, pharyngitis, periodontal disease, and signs of systemic disease should be looked for.
The term "shotty" is commonly used to describe lymphadenopathy. Shotty means shot-like, which refers to bird shot (tiny beads) or buck shot (bigger beads). Shotty lymphadenopathy could refer to a matting of lymph nods with tiny bumps, medium bumps or big bumps. This term is vague and it may be preferable to use more accurate terminology.
Most patients with lymphadenopathy clinically assessed to be due to a minor infection do not require any laboratory testing. Laboratory work up to consider in a patient with a potentially more serious presentation of lymphadenopathy includes PPD, HIV screening, throat culture, CBC, blood culture. Serologic studies for EBV (Epstein-Barr virus), CMV (cytomegalovirus), HIV, Treponema pallidum, Toxoplasma gondii, or Brucella can be helpful in selected cases. For a patient with a fluctuant node where an abscess is suspected, ultrasound may be helpful. Needle aspiration of a suspected abscess may negate the need for an ultrasound but this approach is more invasive. Although a needle aspirate can yield the organism contained within an abscess, most abscesses will have to be surgically drained anyway. Occasionally, a lymph node biopsy may be needed. This tissue is usually sent for gram stain, bacterial culture, acid fast stain, mycobacterial culture, or Bartonella henselae (cat scratch disease) PCR. A chest x-ray evaluation should also be considered to rule out mediastinal masses/malignancy.
The differential diagnosis for lymphadenopathy is best based upon the presentation as either acute bilateral cervical lymphadenitis, acute unilateral pyogenic (suppurative) lymphadenitis, and chronic cervical lymphadenopathy. The most common causes of acute bilateral cervical lymphadenitis are URI viruses such as adenovirus, influenza and RSV. Viruses that typically cause generalized lymphadenopathy such as EBV and CMV may also present as acute bilateral cervical lymphadenitis. The most common causes of acute unilateral pyogenic (suppurative) lymphadenitis are Staph aureus and group A strep. Most of these children are 1-4 years of age. The typical clinical course of lymphadenitis due to group A strep, is manifested in association with group A strep tonsillitis, both of which respond to penicillin. Abscess formation and the need for surgical drainage are uncommon with group A strep. However, Staph aureus more commonly forms abscesses and I&D will almost always be necessary. If there is a prior history of dental problems or a dental abscess, anaerobic oral flora may be the cause. The differential diagnosis for chronic cervical lymphadenopathy is more extensive. The most common causes of prolonged cervical lymphadenopathy are infectious such as atypical mycobacterial infections, mycobacterium tuberculosis, cat scratch disease, EBV, CMV, toxoplasmosis, histoplasmosis and HIV. Noninfectious etiologies for chronic cervical lymphadenopathy include malignancy such as leukemia, lymphoma, metastatic solid tumors such as neuroblastoma, rhabdomyosarcoma and nasopharyngeal carcinoma. One other important etiology that does not fall into the above categories is Kawasaki disease. Kawasaki disease is associated with a single, nontender, nonpurulent enlarged cervical lymph node.
Since most cases of acute bilateral cervical lymphadenitis are viral in etiology and self -limited, only symptomatic treatment is recommended. For children with acute unilateral pyogenic (suppurative) lymphadenitis caused by Staph aureus or group A strep who do not appear toxic and have no apparent abscess or cellulitis oral empiric therapy with cephalexin, oxacillin or clindamycin is recommended. For ill appearing children who have abscess formation or cellulitis, needle aspiration or I&D and IV therapy with clindamycin or vancomycin is recommended. For children who have cervical lymphadenitis associated with periodontal disease, needle aspiration or I&D and therapy with penicillin or clindamycin are optimal. For suspected nontuberculous mycobacteria infection, surgical excision of the infected lymph node without antibiotic therapy is optimal. For cat scratch disease following needle aspiration and PCR diagnosis of Bartonella infection, no antibiotic therapy is routinely recommended, although this is controversial since azithromycin has some clinical efficacy.
The prognosis for lymphadenopathy and lymphadenitis depends upon the etiology. In general, since most childhood acute bilateral cervical lymphadenopathy is viral in etiology, the prognosis is good. Since most acute unilateral pyogenic (suppurative) lymphadenitis is caused by Staph aureus and group A strep, and is easily treatable, the prognosis is also good. Since the differential diagnosis for chronic cervical lymphadenopathy is more extensive, generalized statements about prognosis are difficult to make.
Lymphangitis is the inflammation of the lymphatic vessels. The etiology of lymphangitis can be neoplastic or benign. If the lymphatic vessels are infiltrated by tumor cells, surrounding fibrosis takes place producing visible or palpable cords. Lymphangitis is sometimes seen proximal to areas of cellulitis (especially those caused by group A strep) as red streaks extending from the cellulitis proximally. Such cases are treated similar to cellulitis alone.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
groovy2
Frequent Contributor (1K+ posts)
Member # 6304
posted
Hi Dan
Cats Are carriers of strep--
I bet your cats sleep with you --
When I was a kid I kept getting strep- our pet cat slept with me--
Years later I found out about cats being carriers of strep --it sure made scence after finding this out--Jay--
Posts: 2999 | From Austin tx USA | Registered: Oct 2004
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Aniek
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My LLMD sees many patients with cronic strep. Chronic step can cause a reactive arthritis.
She thought I had it because of initial symptoms, which include shoulder and hand pain.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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Hmmmm...this is all very interesting. I have 2 cats. They were shelter cats. I did eat goat yogurt yesterday and today for breakfast, but I thought that was different from cow milk yogurt.
I had my tonsils out a second time when i was 35 (now 52) for constant sinus, throat issues. This was before I knew I had Lyme. My sis the nurse practitioner thinks i have scar tissue that harbors the strep.
When all this struck bad 2 years ago I saw two ENT's both of whom coudn't see any problem, altho an MRI showed a Thornwaldt cyst somewhere back there. One ENT said he didn't think removal of the cyst would help the constant clearing of my throat.
So I guess my plan is to wait a week and have another throat culture and stay away from the goat yogurt for a few days. And take the cats to the vet to see what can be done about testing them.
posted
I THINK goat yogurt can also cause the throat phlegm.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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bpeck
Frequent Contributor (1K+ posts)
Member # 3235
posted
Have you been on long term abx before Strep bout?
People forget that when we're on long term abx, it disrupts not only the flora in our intestine- but also the flora in the throat, lungs, ears, mouth etc-
So, you can be more suseptible to some things while ON abx (depending on the abx, of course).
David95928
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Member # 3521
posted
I wonder whether the penicillin actually did the job. It's my impression that it is usually treated with Zithromax and/or a shot of Bicillin LA.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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oxygenbabe
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posted
Are you Type O? Antigens on type O blood are similar enough to antigens on strep that Type O blood types may have more trouble fighting strep.
Posts: 2276 | From united states | Registered: Jun 2004
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groovy2
Frequent Contributor (1K+ posts)
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posted
Strep throat is real common--
Most good docs know what it looks like so no test really nessiary--
From experance I will tell you what to look for--
Your throat will look redder -- (back of your throat by toncles)
A a spot about the size of a dime will look brighter red-- in this area there will be a few small bumps (1 or 2 )
The bumps will have a white yellow color(puss) -- like small white pimples--
( they look exactily like a Fire Ant bite bump)--
As infection ages there can be a small patch of white around the bumps--
Your spit is usually thicker and you sometimes have the erge to clear your throat spit ect--
Penicillin is what is commomly used to treat and if injected it can have you feeling better in a few hours-Jay--
Posts: 2999 | From Austin tx USA | Registered: Oct 2004
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TheCrimeOfLyme
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Dan
I get strep throat alot. I ALWAYS get it come SEptember of every year ( im so jumping for joy).
My kids live with it, I swear. I had their tonsils out ( as well as I did) and that reduced the infections, but we still get them.
We have cats as well.
-------------------- You want your life back? Take it. Posts: 3169 | From Greensburg, Pennsylvania | Registered: Jun 2003
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