Please help - 4 mo old with scarlet fever - UPDATE with more ?

[JessieBird]

(will x post in health and healing)

Hi everyone - I've been laying low since DS2 was born but I would really appreciate some advice now. Background: I have had a very resistant strep infection since mid-December. Three different antibiotics have done nothing, nor has large doses of GSE. In December when it first hit I ended up in hospital with a very high fever for 48 hours and then developed the severe joint inflammation and other advanced symptoms despite antibiotics. I'm going for heart tests on Thursday in case I had/have rheumatic fever. I'm quite freaked out and not sure what to do next for myself...but that's another post. Anyway, I hadn't been worried about my baby because I've read over and over that breastfed babies don't get strep but now I'm 99% certain that he has scarlet fever. His rash matches every description and photo I can find. Even though he didn't have symptoms then, our doctor swabbed him along with DS1 and DH on Friday just to make sure they were clear but I haven't heard back from her yet. Now in hindsight I realize that DS2 was very fussy at the breast on Friday and Saturday, perhaps his throat hurt. Now he's nursing fine but the rash has appeared, starting yesterday at his neck (I thought it was drool rash at first) and spreading all over his body today. He's never had a fever. Because the strain I have is turning out to be so resistant and because of the risk of heart problems and arthritis, I'm pretty nervous about this.

So...thanks for reading this far. My question is - does strep always have to be treated with antibiotics? Can it be allowed to run it's course on its own especially if there hasn't been any fever? I really don't want to expose my baby to antibiotics especially if they may not kill the bacteria anyway. How seriously should I take my baby's rash?

Of course I will try to get through to my doctor tomorrow (not easy) but I'm going to be up worrying all night so would love to hear what you think.

Thanks!

[Llyra]

I did quite a bit of research on this awhile ago. I was trying to avoid antibiotics for my own strep infection, because of my underlying chronic illness. What I learned was that it is sometimes feasible to leave strep untreated in healthy adults, and it will resolve on its own, but that because of the (albeit unlikely) risk of rheumatic fever, and the risk of the infection becoming serious very quickly, it is always recommended that children be treated with antibiotics with a confirmed strep infection. So yeah, I am not an expert, but I would be getting the antibiotics, if it were my child. I wouldn't hesitate. I would be getting the child to a health professional as soon as possible, and would cooperate in antibiotic therapy if strep is confirmed. However, in the absence of any fever, it may very likely be that he HASN'T got it, and that this rash is something different. So I think getting him checked out would be my first priority, in your position.

And to you. It sounds like you've been through a lot with your own health, and now having to worry about your LO must be really upsetting and scary. I will be hoping for you that it turns out to be nothing!

FWIW-- my DD2 had a resistant strep pneumonia last winter, and after multiple antibiotics wound up in the hospital. It was IV clindamycin for 36 hours that finally knocked out the infection.

[Llyra]

FWIW, though-- if I had a doctor I couldn't get through to, in a serious situation, on a weekday-- I think I'd be shopping for a new doctor. Is it really that hard to get hold of yours? I don't think I'd feel comfortable letting it go-- I'd really want to KNOW for sure, ya know?

[Snapdragon]

I know my pediatrician has a way that you can call their office ANY time- I think day  or night- and an answering service will answer if you press the # to indicate an emergency. Then they call the nurse on call who calls me right back to give me an actual medical opinion- I would do this if I were you- call the doctors office and get someone to call you back. Does your doctor's office have this type of service? I thought it was pretty standard-

[Marsupialmom]

It is extremely unlikely your baby has scarlet fever. 

How are you dressing him?  Heat rash can look like strep.  My poor nephew had this problem repeatedly until the doctor got quite rude to my sil.  

Contact rashes can be frustrating and can come without fever.  New Soaps, reformulated soap, someones purfumes, et 

Or it can be a nasty case of thrush. I have had kids have thrush/yeast infection that doesn't have the mouth spots. 

[MeepyCat]

Originally Posted by Marsupialmom 

It is extremely unlikely your baby has scarlet fever. 

How are you dressing him?  Heat rash can look like strep.  My poor nephew had this problem repeatedly until the doctor got quite rude to my sil.  

Contact rashes can be frustrating and can come without fever.  New Soaps, reformulated soap, someones purfumes, et 

Or it can be a nasty case of thrush. I have had kids have thrush/yeast infection that doesn't have the mouth spots. 

Heat rash?  In Quebec?  In February?

If mama has had such a resistant case of strep that they're checking her out for rheumatic fever, I'm afraid that I don't think it's all that unlikely that baby could have scarlet fever.

[Llyra]

Allergic rashes can look that way, as well-- my DS gets a similar rash when he eats soy protein in any amount. The lack of fever really does seem reassuring, as far as scarlatina. But I do agree that with the OPs health history, it does seem like scarlatina is a reasonable possibility.

[JessieBird]

Thanks everyone - I did get through to my doctor's office after-hours service and an actual doctor called me back (easier than i'd expected, a very pleasant surprise!). She said to head in first thing in the morning but not to be too alarmed because he hasn't had a fever. I am trying to think of anything else that could cause such a rash and, despite being in Quebec in the middle of February and -15C outside right now and barely 21C inside, heat rash did cross my mind. I started swaddling him to sleep three days ago, which would coincide exactly. Except that this rash is most pronounced on his neck, and has spread to his face this evening, two areas that are exposed despite the swaddle. He does also have a persistent yeasty bum rash that comes and goes. I thought I had it licked but it just came back a few days ago (because of antibiotics in my breast milk?). I really don't think he could have a yeast rash all over his body, though similar it doesn't really look the same. The body rash is dry and sandpapery, the yeasty bum is not. But I have been giving him some bioK probiotics from my finger over the last few days, maybe he's having a reaction to that.

But I think I'm grasping at straws here. We have some serious strep in our house and I have to assume my baby's caught it until proven otherwise. Argh.

Another thought - I swaddled him to sleep the last few days because he started swiping at his face and it kept him from relaxing. I thought it was just him fussing a bit as he gave in to sleep but maybe it was a sign of a sore throat or some other discomfort due to illness. He's totally chill and happy, as usual, otherwise so it never occurred to me that he could be sick.

[Marsupialmom]

Originally Posted by MeepyCat 

Heat rash?  In Quebec?  In February?

If mama has had such a resistant case of strep that they're checking her out for rheumatic fever, I'm afraid that I don't think it's all that unlikely that baby could have scarlet fever.

Yes,over dressed people in the winter time can get heat rashes.  Thats when my nephew got it, because he was WAY over dressed all the time. 

Keratosis pilaris and 5th disease pop in my head but doubt the second one.  

[Marsupialmom]

Jessie, I know I sound crazy but I swear I have a child that has had every imaginable rash -- multiple times.  

One time we found out the rash was reformulated laundry detergent.  They don't always tell you that!  Grr!!  

Once later we found out our mil nicely washed clothes we left over there using fabric softner.  We suspected because my dd got crabby in her present and had gotten a couple of rashes.  

This is a picture of a yeast infection on neck that became common http://getridofyeast.org/  Yeast on the "truck" of the body can look different than the folds of the skin.  

[JessieBird]

Thank you Marsupialmom! You have reassured me that there are so many possible explanations for this. Not that a yeast infection or skin sensitivities are necessarily easy to diagnose and treat, but far less frightening than strep.

[earthmama369]

I had scarlet fever when I was pregnant with ds. I had had a mild sore throat -- nothing that felt like strep to me -- and treated it with honey and herbal teas, pregnancy-safe throat lozenges, etc. No fever at all. It went away, but a few weeks later, I got a dry, sandpapery rash all over my body. It was horrid. Itchy and painful. It started at the joints (hips, elbows, wrists) and spread from there. That's pretty common with scarlet fever rashes and can help distinguish a scarlet fever rash from the million other kinds of rashes. I still didn't have a fever, and even though my throat felt fine by that point, I still came up positive for strep on a rapid strep test, which was the final piece for diagnosing scarlet fever.

I know it's scary, but with treatment, scarlet fever in children (and adults) can be resolved without compromising their long-term health. However, I wouldn't wait on it. I'd definitely head in first thing in the morning and ask for a rapid response strep test. They can do the one that takes longer for confirmation, as well, but doing the rapid response test can get you on a path of treatment much sooner, and in a baby that young, I'd feel better getting treatment asap if necessary.

[JessieBird]

Thanks everyone for your feedback, I really appreciate it - the mystery got deeper today. I went to the doctor and was thrilled when the nurse told me that they'd just gotten our cultures back (the whole family was swabbed last Thursday even though at the time I was the only one with symptoms) and my baby and I were negative! I was so relieved. However, when we got in to see the doctor and she took a look she said without a doubt it's scarlet fever - totally classic presentation with the little lines in the armpits and all - and both my throat and my baby's show signs of strep. She figures there are two possibilities - our symptoms are caused by something else or the tests were faulty. She re-swabbed us and sent them for 48 hour cultures. (My doctor's office doesn't do rapid strep tests in cases like this because the rate of error is so high.)

Then we talked through what to do now. Because my strep became so severe so quickly back in December and affected my kidneys and joints (maybe my heart too, find out tomorrow), I'm EXTREMELY concerned that the same could happen to my baby before we get the test result back. I could certainly wait 48 hours to get the new swab results but I opted to fill a prescription for amoxicillin for my baby right away. But I haven't given it to him yet. It's in the fridge waiting for me to decide. What would you do?

[Snapdragon]

I don't know anything about how safe amoxycillan is for babies- though if the doctor prescribed it then it probably is. If it is then I personally would do the antibiotics. I am taking amoxucillan right now for something and I am not at all one to jump into meds- but I think antibiotics do really work and for something dangerous and really can heal things- I wuold look into more info about how it effects little babies- which I have no idea- but also you can give the baby probiotics along side of it to ease the side effects. Good luck

[Llyra]

I would give the amoxicillin, quite frankly. And I'm a wait-and-see person. However, I am guessing you probably need to get yourself treated, as well, or you and baby are going to be reinfecting each other.

[Marsupialmom]

Jessiebird -- hugs this has to be very scary for you.  I would do antibiotics.  

[1stTimeMama4-4-10]

I would do the antibiotics.  If it turns out it wasn't necessary, so be it. If it turns out it was, be thankful you started sooner rather than later. 

[Laurski]

Oh, mama, I'm so sorry you're dealing with all of this.    How scary this must all be for you.

I've had lots and lots of experience with Strep A, and it's not fun.

For yourself--Are your tonsils the source of the infection?  If so, would you consider getting them removed?  (I had antibiotic-resistant strep in my tonsils many years ago, testing positive for strep over 17 times (I stopped counting) in a year.  Once I had my tonsils removed, no more strep.)

For your baby--I'd give him the antibiotics.  I had scarlet fever twice when I was a baby, and with antibiotics was able to recover just fine.  As another poster said, if the in this case it's probably better to give the antibiotics now, just to start sooner rather than later, even if it turns out ultimately that he didn't need them.

I hope your heart tests go well, and hope your son shows rapid improvement.  Please let us know how you're doing.