Can Allergy Shots Cause Muscle And Joint Pain?
If the aches are due to strep, how long should it take to cease? And if the aches are due to allergy shots, will antihistamines help prevent or stop them?
If the one day episode of 103 fever, vomiting, and fatigue was improved within 12 hrs after starting augmentin, is it more likely that she had strep? If yes, is it normal that the aches are still going on after 1 1/2 weeks on antibiotics?
If due to strep, would procalcitonin levels still be elevated even on antibiotics, making it a useful diagnostic tool as to the cause?
Spoke with her allergist who claims he has never had a patient doing allergy shots that experienced muscle aches.
Suggestions on allergy shots and streptococcal related joint pains
Detailed Answer:
Hi... I understand your concern.
Coming to your queries -
1. Allergy shots can trigger muscle/joint pain in the ankles, wrists, knees, back, and calves. But it is very very unusual and rare to occur as a late response like what you are describing. usually it will be an immediate response to the allergy shot.
2. Streptococcal sore throat causing joint symptoms is called rheumatic fever. But in this the fever sore throat will precede the joint pain by 2-3 weeks. But here in your case the joint symptoms started first followed by sore throat. So it is unlikely to be due to streptococcal. Moreover only streptococcal sore throat or pharyngitis can cause rheumatic fever and not any other streptococcal infection.
3. If it is due to strep - ASO titre raising four fold in 4 weeks can give you an answer. Even a single titre of more than 300 can be corroborative evidence.
4. Aches due to strep will have dramatic response to NSAID or pain killer drugs like Ibuprofen or Aspirin. Pain due to allergy shots is rare and there is no literature evidence to say in how many days it will settle (as the condition itself is questionable).
5. Fever going off immediately after Augmentin can be a corroborative evidence of strep infection but not confirmatory. It can even be a viral illness. To be sure about strep - a rapid streptococcal antigen test should have been done along with a throat swab culture. If it is positive then the kid will require antibiotics. If it is negative then it might be viral illness and doesn't require antibiotics at all.
6. Even if it is strep infection the duration of antibiotics is only 10 days and not 1.5 weeks.
7. In acute situations I would depend on Procalcitonin. But in such long standing inflammation like this Procalcitonin is likely to be elevated as it is basically an inflammatory marker.
The possibilities I put forth are -
1. Viral illness induced joint pains and muscle pains.
2. Connective disorder like polyarticular rheumatoid arthritis or SLE.
3. Chronic fatigue syndrome.
Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,
And if her fever and vomiting were a virus, that could cause joint pain persisting for longer than six weeks?
Streptococcal infection in throat alone can cause joint pain
Detailed Answer:
Hi... Coming to your queries directly -
1. Only streptococcal infection in throat can cause joint pain. Streptococcal infection elsewhere cannot cause joint pain.
2. Yes, viral illness can cause prolonged joint pain like this.
Regards - Dr. Sumanth