More parents of children with 'rare' strep A complications want answers

After reading about 11-year-old Nupur Mate's battle with septic shock from a serious group A strep infection, two different parents are sharing similar stories of their child's brush with death and are demanding answers to why doctors assume flu at first sight.

It wasn't until four-year-old Emanuel Cherian's body was in septic shock that streptococcus A bacteria was discovered in his blood. His father, Boney Cherian, said the boy's vomiting and fever weren't getting better with Tylenol and rest – the advice they were first offered by doctors at their local hospital. "We went straight to SickKids," Cherian said, adding that they arrived just before his son's heart stopped.

"Nobody expected him to survive the first night," Cherian said.

Heavy doses of antibiotic treatment cleared Emanuel's sepsis before his organs failed and he's now home recovering well. His parents, however, are still struggling with how the infection went unnoticed before it was almost too late. Boney Cherian said he will file a complaint with the ombudsman of their local hospital. 

Most people, and doctors, don't expect the common group A strep bacteria to develop into anything worse than strep throat. But unfortunately for Emanuel Cherian, Nupur Mate and Armin Jalalvandi, aged two-and-a-half, they make up the small population of cases that are anomalies. 

Although Mohammad Jalalvandi's son didn't experience cardiac arrest, Armin's soreness in his hip and fever were mistaken for influenza symptoms. Once at SickKids days later, doctors told him his son was within seconds of not surviving.

"So they rushed for surgery on his hip and drain the infection and the transfusions because the level of infection was so high in his blood," Jalalvandi said. As with the other cases, it wasn't until the septic shock set in that strep A was found in his blood. 

"I just think if they prescribed antibiotics from the beginning, it could have prevented this thing," Jalalvandi said. 

Serious group A strep is hard to diagnose


A serious group A strep infection is one of the hardest infections to diagnose, according to infectious disease expert Dr. Allison McGeer. Even blood work done at the first hospital visit can miss the septic shock that might be brewing. 

"Early on in your group A strep, you may well not have the bacteria in your bloodstream or not in sufficient concentration in your bloodstream to be detectable," McGeer said.

To Jalalvandi's question of whether early prescriptions for antibiotics could have stopped his son's infection from advancing so quickly, McGeer said that policy would cause more harm than good.

"If we treat them all with antibiotics, we expose them to the adverse affects of them," which she said are uncommon. However, over-prescribing is too risky because the majority of fever cases are not caused by bacterial infection, she said.

"Of course people are upset and angry when things go wrong and I am equally sure that any physician who treated this child is also upset," McGeer said.

"We have very well-trained physicians and a great health-care system, for all its failings. But that does sometimes create the impression that doctors are always right and that's not possible no matter what resources you have."