Skin hives after strep/penicillin
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Rick Duf
#1 / 7
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 Skin hives after strep/penicillin This isn't a problem post - this is a cure post. I thought I'd post it in case it is useful to anybody, or if anyone has any comments on it... In mid December, I had been under a lot of stress, and then
developed what was probably strep (though I had no cultures
taken, the doc said it looked like strep.) I was also having
very painful joint swelling, and something like hives.I went on
antibiotics (penicillin), and was on it for 3 weeks. Somewhere in
here I also had {*filter*} tests done. Eventually, the swelling
(which migrated from joint to joint) settled in a few
places. I went off antibiotics, and on naproxin, (to help the
swelling). The swelling slowly went away, but I still had the
hiving. Every evening it would come back, and every morning
it would be gone. So the doc had me start taking benydril
(an antihistamine), and said if I still had any hiving in two weeks,
to come back and he'd do more {*filter*} tests.
In the mean time, I went to my chirpractor for a neck crick. While
there, I mentioned the hives. He said that often after an infection
and antibiotics, some of the essential bacteria in your colon can be
killed, and should be replaced, so many people suggest eating yogurt
after this kind of episode. He gave me a bottle of lactobacillus A&B
capsules. I started taking them, and in two days the hiving went
from fairly major occurances, to virtually nothing.
So far, I've had no further problems.
I was curious why my medical doc didn't mention the yogurt/bacteria
stuff. Is this something that everybody (except me) just knows? Do
you think it really helped, or was just a coincidence (though I doubt
it, since I had the hives for six weeks, and it disappeared after the
first full day of taking the capsules).
... Rick
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| Sun, 14 Jul 1996 02:48:23 GMT |
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Rick Duf
#2 / 7
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Skin hives after strep/penicillin
Quote:
> >I was curious why my medical doc didn't mention the yogurt/bacteria
> >stuff. Is this something that everybody (except me) just knows? Do
> >you think it really helped, or was just a coincidence (though I doubt
> >it, since I had the hives for six weeks, and it disappeared after the
> >first full day of taking the capsules).
> Rick,
> From personal experience, I suspect the doctor assumed you had hives
> because of the penicillin. I can't recall how long it took, but mine
> went away after I stopped the penicillin. I was also, at the time,
> taking another drug commonly used to treat allergic reactions to
> penicillin, and that may have speeded my recovery (or made the symptoms
> less severe). Are you sure you weren't having a reaction to the
> penicillin?
> PMG
I was actually hiving before I started the penicillin - it was one of the reasons I decided to go to the doctor. I know it did occur to him, becuase when I mentioned the hives, he would always ask if it started after I began taking the penicillin. The hives did get worse, though, after I started taking the penicillin, but then somewhat subsided again. I wondered the same thing you did, but there didn't seem to be a good match-up between taking the antibiotic and the hives. I was off the penicillin maybe two weeks, with no big reduction in the hiving, when I started the lactobacillus. And ln less than two days later, bang, no more hiving. So, it's possible (and I still wonder about it myself), but I think the odds favor the lactobacillus A&B. ... Rick "I want to find a decent place, where people
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| Sun, 14 Jul 1996 06:48:47 GMT |
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Phyllis Gilmo
#3 / 7
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Skin hives after strep/penicillin
Quote:
>I was curious why my medical doc didn't mention the yogurt/bacteria
>stuff. Is this something that everybody (except me) just knows? Do
>you think it really helped, or was just a coincidence (though I doubt
>it, since I had the hives for six weeks, and it disappeared after the
>first full day of taking the capsules).
Rick, From personal experience, I suspect the doctor assumed you had hives
because of the penicillin. I can't recall how long it took, but mine
went away after I stopped the penicillin. I was also, at the time,
taking another drug commonly used to treat allergic reactions to
penicillin, and that may have speeded my recovery (or made the symptoms
less severe). Are you sure you weren't having a reaction to the
penicillin?
PMG
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| Sat, 13 Jul 1996 22:06:10 GMT |
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GD Rubenfel
#4 / 7
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Skin hives after strep/penicillin Quote: >In mid December, I had been under a lot of stress, and then
>developed what was probably strep (though I had no cultures
>taken, the doc said it looked like strep.) I was also having
>very painful joint swelling, and something like hives.I went on
>antibiotics (penicillin), and was on it for 3 weeks. Somewhere in
>here I also had {*filter*} tests done. Eventually, the swelling
>(which migrated from joint to joint) settled in a few
>places. I went off antibiotics, and on naproxin, (to help the
>swelling). The swelling slowly went away, but I still had the
>hiving.
Hmmmm. Strep infection + rash + migratory arthralgia. Anyone got those modified Jones criteria handy - Rheumatic Fever? A disease with endlessly pimp-able eponyms (Carey-Coombs murmur, Aschoff bodies). Sounds as if this is what your doc was thinking, too. You can check an anti-streptolysin O titer to confirm. You and your doc should consider penicillin prophylaxis against future strep infection if the ASO titer is positive or the clinical picture is strong for RF. Quote: >In the mean time, I went to my chirpractor for a neck crick.
Uh oh. Quote: >While there, I mentioned the hives. He said that often after an
infection
>and antibiotics, some of the essential bacteria in your colon can be
>killed, and should be replaced, so many people suggest eating yogurt
>after this kind of episode. He gave me a bottle of lactobacillus A&B
>capsules.
Hives have nothing to do with colonic bacteria micropopulations. Lactobacillus has been proposed as a way to treat antibiotic associated
diarrhea (NOT C. difficile diarrhea). I frequently use it in hospital
acquired culture negative diarrhea - though I think psyllium works
better. At least one good study found lactobacillus ineffective:
A double-blind, placebo-controlled study of the efficacy of Lactinex in
the prophylaxis of amoxicillin-induced diarrhea.
Dicp, 1990 Apr, 24(4):382-4.
Quote: >I was curious why my medical doc didn't mention the yogurt/bacteria
>stuff.
Now you know.
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| Mon, 15 Jul 1996 03:05:53 GMT |
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Rick Duf
#5 / 7
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Skin hives after strep/penicillin
Quote: > >In mid December, I had been under a lot of stress, and then > >developed what was probably strep (though I had no cultures > >taken, the doc said it looked like strep.) I was also having > >very painful joint swelling, and something like hives.I went on > >antibiotics (penicillin), and was on it for 3 weeks. Somewhere in > >here I also had {*filter*} tests done. Eventually, the swelling > >(which migrated from joint to joint) settled in a few > >places. I went off antibiotics, and on naproxin, (to help the > >swelling). The swelling slowly went away, but I still had the > >hiving. > Hmmmm. Strep infection + rash + migratory arthralgia. Anyone got those
> modified Jones criteria handy - Rheumatic Fever? A disease with
> endlessly pimp-able eponyms (Carey-Coombs murmur, Aschoff bodies).
> Sounds as if this is what your doc was thinking, too. You can check an
> anti-streptolysin O titer to confirm. You and your doc should consider
> penicillin prophylaxis against future strep infection if the ASO titer is
> positive or the clinical picture is strong for RF.
Thanks for your reply. Actually, I did kind of a stupid thing - I know almost nothing about medicine and things, and one Sunday while I was confined to my living room because of swollen joints, I started reading medical-type books, trying to diagnose myself. I finally decided I had Rheumatic Fever, and beeped my doctor and suggested this. He didn't seem too concerned, and told me to come in in a day or two. I had been on penicillin for a week then. Later at the appointment, he said that even it it had been RF, the penicillin would have taken care of it. In any case, I was never really aware of any fever (though if it wasn't too serios, I wouldn't have noticed). Quote: > >In the mean time, I went to my chirpractor for a neck crick.
> Uh oh.
Uh oh? Quote: > >While there, I mentioned the hives. He said that often after an > infection > >and antibiotics, some of the essential bacteria in your colon can be > >killed, and should be replaced, so many people suggest eating yogurt > >after this kind of episode. He gave me a bottle of lactobacillus A&B > >capsules. > Hives have nothing to do with colonic bacteria micropopulations.
He didn't say that they would help hives actually - but he did say my colon was stressed, and could be causing other problems. Quote: > Lactobacillus has been proposed as a way to treat antibiotic associated > diarrhea (NOT C. difficile diarrhea). I frequently use it in hospital > acquired culture negative diarrhea - though I think psyllium works > better. At least one good study found lactobacillus ineffective: > A double-blind, placebo-controlled study of the efficacy of Lactinex in
> the prophylaxis of amoxicillin-induced diarrhea.
> Dicp, 1990 Apr, 24(4):382-4.
> >I was curious why my medical doc didn't mention the yogurt/bacteria
> >stuff.
> Now you know.
Still, 6 weeks of hives, and gone two days after I start the lactobacillus. (my doctor had me on benydril, but I don't think it was doing much. I went off it once, and the hives cam back strong. I went off it again when I started the lactobacillus, and the hives went away. To the patient (i.e., me), it sure looked like that cured things. Also, though I don't know what "anti-streptolysin O" means, I
notice it was on a list of things I was {*filter*}-tested for
(including Arthritis Panel, C-Reactive Protein, Hemogram PLT Count
Automated, and RBC,PLT,WBC Historams.) I don't know what the results
meant, except that my "arthritis count" was high (so was my white
{*filter*} count), but that's all I remember. What else should I ask
about these, and what will the answers mean?
.. Rick
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| Tue, 16 Jul 1996 03:36:57 GMT |
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Gordon Rubenfe
#6 / 7
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Skin hives after strep/penicillin
Quote: >Thanks for your reply. Actually, I did kind of a stupid thing - I know
Reading about your own body is never a stupid thing. Quote: >almost nothing about medicine and things, and one Sunday while I was
>confined to my living room because of swollen joints, I started reading
>medical-type books, trying to diagnose myself. I finally decided I had
>Rheumatic Fever, and beeped my doctor and suggested this. He didn't seem
>too concerned, and told me to come in in a day or two. I had been on
>penicillin for a week then. Later at the appointment, he said that even
>it it had been RF, the penicillin would have taken care of it. In any
>case, I was never really aware of any fever (though if it wasn't too
>serios, I wouldn't have noticed).
Fever is one of the minor criteria for rheumatic fever, oddly enough. Quote: >> >In the mean time, I went to my chirpractor for a neck crick.
>> Uh oh.
>Uh oh?
Yes, uh oh for two reasons. One, because your chiro-guy is undoubtedly going to say something stupid and two because spinal neck manipulation is something of a topic non grata around here. Quote: >He didn't say that they would help hives actually - but he did say
>my colon was stressed, and could be causing other problems.
There, see, I told you your chiro guy would say something stupid or at least meaningless. I wonder, if pushed, if he could even put together a fanciful explanation of what in the world this phrase means. Care to ask him and post his reply?? Along with any references from his extensive library, of course. Quote: >Still, 6 weeks of hives, and gone two days after I start the lactobacillus.
First of all, we have to agree that you have hives. How can you be sure that these are not the subcutaneous nodules or erythema marginatum of rheumatic fever?? I'll just quote here from my handy _Dermatologic Signs of Internal
Disease_ "Urticaria [hives] is a cutaneous vascular reaction pattern
characterized by well circumscribed areas of dermal edema and erythema.
By definition, lesions resolve within 24 hours." Certainly people are
afflicted with recurrent (chronic) urticaria but lesions resolve within 24
hrs.
I'll just repeat that there is no known association between lactobacilli,
gut flora, or colonic stress and hives. As far as temp{*filter*}sequence
connoting causal relation, this is a logical fallacy so old there's even a
Latin phrase for it, "Post hoc ergo propter hoc" (wink to JB).
Quote: >Also, though I don't know what "anti-streptolysin O" means, I
>notice it was on a list of things I was {*filter*}-tested for
>(including Arthritis Panel, C-Reactive Protein, Hemogram PLT Count
>Automated, and RBC,PLT,WBC Historams.) I don't know what the results
>meant, except that my "arthritis count" was high (so was my white
>{*filter*} count), but that's all I remember. What else should I ask
>about these, and what will the answers mean?
Well, Rick, it's not quite the right medium to explain each of these tests. ASO measures an antibody response to a protein on streptococci. If your ASO was negative, it makes the diagnosis of RF pretty unlikely. OTOH, if it's positive, since many of us have been previously strep-infected, it does not necessarily make the diagnosis. For this you need a consistent history and exam. BTW, since I've never actually seen a case of RF, I'd happily stand corrected on this by anyone with more experience. Is there ASO neg RF? How would you know it's not another post-infectious arthropathy? Reiters, eg? I'll also point out here that *rheumatic* fever and *rheumatoid* arthritis
have absolutely nothing in common but their first seven letters. They are
totally distinct diseases.
gordon
--
______________________________________________________________________________
Gordon D. Rubenfeld, M.D. UCSF
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
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| Thu, 18 Jul 1996 10:26:19 GMT |
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Rick Duf
#7 / 7
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Skin hives after strep/penicillin
Quote:
> >Thanks for your reply. Actually, I did kind of a stupid thing - I know > Reading about your own body is never a stupid thing.
Sorry - what I meant was that I was trying to diagnose myself by reading simple medical references, and then beeping my doctor to tell him what I had. The effort and curiosity was certainly well-meant and well-placed, but I think my tactics were a bit presumptuous. Quote: > >almost nothing about medicine and things, and one Sunday while I was > >confined to my living room because of swollen joints, I started reading > >medical-type books, trying to diagnose myself. I finally decided I had > >Rheumatic Fever, and beeped my doctor and suggested this. He didn't seem > >too concerned, and told me to come in in a day or two. I had been on > >penicillin for a week then. Later at the appointment, he said that even > >it it had been RF, the penicillin would have taken care of it. In any > >case, I was never really aware of any fever (though if it wasn't too > >serios, I wouldn't have noticed). > Fever is one of the minor criteria for rheumatic fever, oddly enough.
That is interesting. In fact, all this is really interesting. I may have to buy more books. :) Quote: > >> >In the mean time, I went to my chirpractor for a neck crick. > >> Uh oh. > >Uh oh? > Yes, uh oh for two reasons. One, because your chiro-guy is undoubtedly
> going to say something stupid and two because spinal neck manipulation is
> something of a topic non grata around here.
I will be interested in seeing this topic come up as a thread - I originally went to my normal doc when I hurt my neck, who said he was one of those bone-doctor people (which title I can't recall), and he did the neck manipulation and fixed a very painful condition. I later went to the chiro because he was recommened, and after I hurt my bneck again. Quote: > >He didn't say that they would help hives actually - but he did say > >my colon was stressed, and could be causing other problems. > There, see, I told you your chiro guy would say something stupid or at least
> meaningless. I wonder, if pushed, if he could even put together a
> fanciful explanation of what in the world this phrase means. Care to ask
> him and post his reply?? Along with any references from his extensive
> library, of course.
That would be ok with me. Remember, though, that I won't really be able to follow up much on whatever answer he gives, (except something like "oh. uh-uh.". Next time I see him, I will ask what it meant when he said my colon was stressed, and why the lacto helped that condition. Quote: > >Still, 6 weeks of hives, and gone two days after I start the lactobacillus.
> First of all, we have to agree that you have hives. How can you be sure
> that these are not the subcutaneous nodules or erythema marginatum of
> rheumatic fever??
I have never been sure what these were. Originally I called them skin rashes. Someone told me that if they come and go (like these did: gone every morning, back every night) that they were hives. I finally told the doc I was assuming these were hives, and he nodded and said "a form of". They weren't really bumpy or itchy though. Just red. They would tend to appear near whatever muscles I most stressed that day (except during the worst of the illness, when they were all over.) Quote: > I'll just quote here from my handy _Dermatologic Signs of Internal > Disease_ "Urticaria [hives] is a cutaneous vascular reaction pattern > characterized by well circumscribed areas of dermal edema and erythema. > By definition, lesions resolve within 24 hours." Certainly people are > afflicted with recurrent (chronic) urticaria but lesions resolve within 24 > hrs. > I'll just repeat that there is no known association between lactobacilli,
> gut flora, or colonic stress and hives. As far as temp{*filter*}sequence
> connoting causal relation, this is a logical fallacy so old there's even a
> Latin phrase for it, "Post hoc ergo propter hoc" (wink to JB). \
I know this isn't logical deduction. Too many variables. Too much uncertainty. Still, when we don't have all the data (which is often the case, at least in my life), we take our best shot. Anyway, this is one of the reasons I posted this in the first place, and I appreciate your taking time to explain some of this to me! Quote: > >Also, though I don't know what "anti-streptolysin O" means, I
> >notice it was on a list of things I was {*filter*}-tested for
> >(including Arthritis Panel, C-Reactive Protein, Hemogram PLT Count
> >Automated, and RBC,PLT,WBC Historams.) I don't know what the results
> >meant, except that my "arthritis count" was high (so was my white
> >{*filter*} count), but that's all I remember. What else should I ask
> >about these, and what will the answers mean?
> Well, Rick, it's not quite the right medium to explain each of these
> tests. ASO measures an antibody response to a protein on streptococci.
> If your ASO was negative, it makes the diagnosis of RF pretty unlikely.
> OTOH, if it's positive, since many of us have been previously
> strep-infected, it does not necessarily make the diagnosis. For this you
> need a consistent history and exam.
As far as I know, I've never had strep (at least, I've never been treated for it), so this still might shed a bit more light on things. Quote: > BTW, since I've never actually seen a > case of RF, I'd happily stand corrected on this by anyone with more > experience. Is there ASO neg RF? How would you know it's not another > post-infectious arthropathy? Reiters, eg? > I'll also point out here that *rheumatic* fever and *rheumatoid* arthritis
> have absolutely nothing in common but their first seven letters. They are
> totally distinct diseases.
Ah - another interesting tidbit there - I was assuming the joint swelling had a common cause. Thanks again for your information! Quote: > gordon
> --
> ______________________________________________________________________________
> Gordon D. Rubenfeld, M.D. UCSF
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
... Rick "I want to find a decent place, where people
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| Sat, 20 Jul 1996 06:40:18 GMT |
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