Streptococcus Pyogens: Clinical manifestation, Diagnosis and Treatment
DISEASES Caused by Strep. pyogens
- Infections typically begin in the throat or skin. The most striking sign is a strawberry-like rash
- Pharyngitis (strep throat):
Sore Throat is the M/C Streptococcal Infection
- Localized skin infection (impetigo)
- Erysipelas(Superficial + S/C Tissue) and cellulitis (superficial form of cellulitis)
- Necrotizing fasciitis
- Scarlet fever:Streptococcal Pharyngitis + Rash with Minute Papules (Sand Paper Skin),
Associated with Circumoral palor + Strawberry Tounge
- Streptococcal toxic shock syndrome
- Autoimmune-mediated complications( rheumatic fever and acute postinfectious glomerulonephritis).
- Genital Infections
- Anaerobic Streptococci are most important cause of puerperal sepsis
9.Bacteremia
- Bacteremia , Pneumonia and Toxic Shock Syndrome
Non Suppurative Complications
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Acute Rheumatic Fever
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Acute Glomerulonephritis
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Post Throat Infection (Any Serotype)
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Skin / Throat Serotypes 49, 53-55, 59-64, 1 & 12
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Repeated Attacks Common
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Not seen |
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Penicillin Prophylaxis Indicated
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Not indicated |
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Course – Progressive / Static
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Self limiting |
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ASO Titre Raised
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May or May not (Skin Infection) Raised
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Marked Immune Response No Change in Complement
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Moderate Immune Response with ↓ Complement Level
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Lab Diagnosis
- Acute Pharyngitis – Swab Culture (Gold Standard)
- Transport Media – Pike’s Media
- Sheep Blood Agar recommended (As it is inhibitory to H. hemolyticus)
- ARF and Ac GN retroscpective with ↑ ASO Titres ( ASO > 200)
- In Ac GN & Pyoderma Anti DNAse and Antihyaluronidase used for retrospective diagnosis
- Streptozyme Test :- Passive Haemagglutination Test (Specific and Sensitive for all Streptococcal Infections)
Management
- Penicillin :- Pharyngitis / Impetigo / Erypsipelas / Cellulitis
- Penicillin + Empyema Drainage:-Empyema or Pnemonia
- Penicillin + Clindamycin + Surgical Debridement :-Necrotizing Fascitis / Myositis
- Penicillin + Clindamycin + i/v Ig :- Streptococcal TSS
Exam Question
DISEASES:
- Infections typically begin in the throat or skin. The most striking sign is a strawberry-like rash
- Pharyngitis (strep throat)
- Localized skin infection (impetigo)
- Erysipelas and cellulitis
- Necrotizing fasciitis
- Scarlet fever
- Streptococcal toxic shock syndrome
- Autoimmune-mediated complications( rheumatic fever and acute postinfectious glomerulonephritis).
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