Strep Throat triggers identical CFS impairments

[sonicthoughts]

Forgive me if there is a better subforum, i'm just getting a handle on PR.

I've had CFS for many years now, diagnosed by 5 drs in the last 3 years and been deteriorating rapidly. The "episodes" are more sever, longer duration and more frequent.

I recently got a sore throat and was diagnosed with strep. This was during a rather sever, lengthy episode, with major cognitive issues (feeling like a zombe, unable to concentrate, lethargy, etc) I started taking amoxacilin and my cognitive issues started improving modestly after 12 hours. Then they started to get much worse, and so did my sore throat, also spreading to my ears and chest.
Dr. switched me to a Z-pack (azithromycin) and 8 hours later, my head started clearing up. I started to feel human! Woke up with a relatively clear head. Now after 24 hours my throat is getting worse, but mild CSF issues and not sure if i'm able to affect the strep with z-pack and may move to a stronger antibiotic.

My initial thought was that the strep, like my recurrent sinus problems or other environmental / diet factors, is triggering my autoimmune system and that is connected to the auto-immune side of CSF.

Then I started to wonder if it was the strep bacteria itself.... what if the exotoxin from strep bacteria (d-lactic Acid) was triggering my symptoms? So I started to look into this and found: http://www.ncbi.nlm.nih.gov/pubmed/19567398 showing a connection. I also learned that strep is in the digestive process and breaks down sugar, again releasing d-lactic acid and causing d-lactic acidosis (http://emedicine.medscape.com/article/167027-overview) and can cause very similar symptoms like fatigue, weakness, cognitive impairment, etc.

I was wondering if the community had similar difficulty with strep or thinks this may be a connection i could consider treating (ie. going after strep bacteria in my body or removing the d-lactic acid.)

Any thoughts appreciated.

 

[halcyon]

When you say spreading to your chest do you mean lungs or some kind of chest pain? Are you having any issues with joint pain? Any fever?

 

[Mary]

@sonicthoughts - that's fascinating. I've never heard of strep bacteria being a cause of acidosis and thus many of the cognitive symptoms of CFS. I don't know what the treatment would be for "Gram positive facultative anaerobic D-lactic acid bacteria" in the gut as described in the pubmed study, but it certainly looks worth pursuing. It's telling that your cognitive symptoms improved with antibiotics.

I'm sure you know that lactic acid buildup is implicated in post-exertional malaise. People with CFS tend to have a low anaerobic threshold - we very easily go into glycolysis, anaerobic metabolism, which causes lactic acid buildup and PEM. Glycolysis is an extremely inefficient energy mechanism, and with this mechanism, it can take days to replenish ATP, instead of every 10 seconds as in healthy people and the Krebs energy cycle. (and if I've misstated this anyone, please feel free to correct it)

I used to get very frequent strep infections, but I never had cognitive impairment, so maybe it was never a problem in my gut, I don't know. It would be interesting to see what you come up with - keep us posted and welcome to the board --

 

[IreneF]

@sonicthoughts - that's fascinating. I've never heard of strep bacteria being a cause of acidosis and thus many of the cognitive symptoms of CFS. I don't know what the treatment would be for "Gram positive facultative anaerobic D-lactic acid bacteria" in the gut as described in the pubmed study, but it certainly looks worth pursuing. It's telling that your cognitive symptoms improved with antibiotics.

I'm sure you know that lactic acid buildup is implicated in post-exertional malaise. People with CFS tend to have a low anaerobic threshold - we very easily go into glycolysis, anaerobic metabolism, which causes lactic acid buildup and PEM. Glycolysis is an extremely inefficient energy mechanism, and with this mechanism, it can take days to replenish ATP, instead of every 10 seconds as in healthy people and the Krebs energy cycle. (and if I've misstated this anyone, please feel free to correct it)

I used to get very frequent strep infections, but I never had cognitive impairment, so maybe it was never a problem in my gut, I don't know. It would be interesting to see what you come up with - keep us posted and welcome to the board --

Ditto with the strep symptoms. I got strep throats regularly as a kid. It was not much like what I've got now.

 

[msf]

KDM published a paper on this a few years ago, but I think these days he would suspect that the antibiotics are having an effect on more than just Streptococcus.

http://www.ncbi.nlm.nih.gov/pubmed/19567398

 

[luludji]

http://www.translational-medicine.com/content/4/1/34

Azithromycin in Chronic Fatigue Syndrome (CFS), an analysis of clinical data

 

[sonicthoughts]

Sorry for the delayed post. It's been an awful few weeks.
I'm not sure if this is the case with most of the readers, but whenever I get ill (bacteria/virus) with something that most people find inconvenient, it hits me like a ton of bricks. This may be due to chronic sinusitis but the bottom line is that I often have trouble distinguishing from CFS and a virus or infection.

Since writing this, I continued to get worse. So both the amoxicillin and z-pack seemed to make me feel better for about a day, then get worse.

Monday morning, I got another strep test which was negative. The doctor (who literally rolled his eyes and stopped looking at me when I said I had CFS) said it must be viral. I still have a soar throat but not as bad as in the past. I have a slight earache and horrible cognitive / fatigue issues.

I have not had any fever associated with this and rarely do. my normal temp is 97 and that is what it's been.


Strep is very rare in adults (less than 10% of sore throats) and rapid test is very high specificity so unlikely false positive.

So I'm hoping this episode may provide a clue and be redeeming and that someone may have similar issues.

CSF is a baffling condition. Perhaps that is all, but still curious if there is a strep connection.

If it was strep and the antibiotics killed it, why did the symptoms get worse?
Could I just have strep in my throat all the time? is that related to CSF?
If it is viral, then what virus (dr. said he is certain it is not mono)

I get occasional sour throats and csf "episodes" but this is really bad. Any thoughts appreciated.

 

[halcyon]

If it is viral, then what virus (dr. said he is certain it is not mono)

Enterovirus and adenovirus are probably the most common.