clinical

Another Sunday, Another Sick Visit, Another Strep Throat

It was just two weeks ago that I wrote about Babygirl’s nasty streptococcal pharyngitis, and how badly I felt about her delayed diagnosis. She not only missed a few days of school with that illness, but she also lost a few pounds that she hasn’t gained back.

So yesterday when she went abruptly from gleefully running through my leaf piles, to curled up on the couch shivering, whispering that she just couldn’t get warm enough, I was on the alert. Sure enough, she had a fever. Overnight, she developed a horrible sore throat, and woke up every hour or so whimpering, crying out in pain. She only wanted ice water, and vomited that up. It was the worst night’s sleep we’ve had in many months.

So when the Pedi’s 7 a.m. call hour opened, I was on it. Our pediatricians are so awesome. Callbacks within the hour. Saturday and Sunday urgent care appointments. We’ve never had to wait more than fifteen minutes for any visit, ever. Super-professional, and they know all the tricks. When Babygirl refused to open her mouth for the swab (having just had this two weeks ago, she knew what was coming) the doctor said, “Okay, I’m just going to hold your nose now,” and gently pinched Babygirl’s nostrils shut, so that she had to open her mouth. The doc snuck the swabs in, and when Babygirl clenched her teeth on them, somehow she convinced her to open up: “We’ll be all done and then you’ll be able to go!”

The rapid came back positive, and we talked about what might have happened. Strep’s been going around the schools, so it was probably a new infection. But it may have been incompletely treated from two weeks ago. Of course, since I didn’t bother to replace her toothbrush, she may have simply given it back to herself. Or, someone in the family may be colonized.

So this time, we’re treating with a cephalosporin, and tossing all the toothbrushes. The pedi suggested a test-of-cure in a couple of weeks. And if she gets it again, we’ve all got to get cultured. (Or, I guess, empirically treated…)

The good thing was that Babygirl perked up a couple of hours after her first dose of antibiotic. I was going to leave her with Nana while Babyboy and I swung by a holiday party for the animal shelter, but she was heartbroken, and wouldn’t be left behind. We didn’t stay long, and I held her for most of it, but still, impressive recovery. (And I didn’t let her touch anyone.)

Once the kids were asleep (6:30 p.m.!) and after the football game (the awful, awful game) I started reading about strep infections. I remembered the worst cases of complicated streptococcal infection I’ve seen, over the years. Puerperal sepsis: the early signs were missed, and a new mother was dead 72 hours after delivery. Necrotizing fasciitis: an athletic young lady progressed from leg pain and chills to full-blown sepsis within six hours, then went into Vfib arrest in the operating room- and survived.

Gave me chills. So I decided to stop reading about it and blog instead. Babygirl is fine, and chances are she won’t get strep throat ever again.

But I may send throat cultures on the whole family in a couple of weeks…

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