Streptococcus Pyogens: Clinical manifestation, Diagnosis and Treatment

Streptococcus Pyogens: Clinical manifestation, Diagnosis and Treatment

Q. 1

True/False statements regarding cellulitis are:

1. Caused by streptococcus pyogenes
2. Causes SIRS
3. Localised infection
4. Abscess if any should be drained
5. I & D should not be done

 

 A

1,2,3 true and 4,5 false

 B

1,3,5 true and 2,4 false

 C

3,5 false and 1,2,4 true

 D

1,2 false and 3,4,5 true

Q. 1

True/False statements regarding cellulitis are:

1. Caused by streptococcus pyogenes
2. Causes SIRS
3. Localised infection
4. Abscess if any should be drained
5. I & D should not be done

 

 A

1,2,3 true and 4,5 false

 B

1,3,5 true and 2,4 false

 C

3,5 false and 1,2,4 true

 D

1,2 false and 3,4,5 true

Ans. C

Explanation:

It is a non suppurative inflammation spreading along the subcutaneous tissue planes and across intercellular spaces.

The term is a misnomer, as the lesion is one of the connective and interstitial tissue and not of the cells.

The causative organism is mostly the streptococcus pyogenes, through a variety of aerobic and anaerobic bacteria may produce cellulitis.

 
Pathology:
The organism usually gains access through a wound and redness at the area of inflammation, but without definitive localization blebs and bullae form on the skin.

central necrosis may occur at later stages.
 
Clinical Feature:
There is varying degree of fever and toxemia.

The affected part is very much swollen and painful.

diabetic individual often suffers from cellulitis. On examination, the affected part is warm, swollen and tender.

There is pitting oedema and brawny induration.

The surrounding lymph vessels may be seen as red streaks due to lymphangitis.
 
The regional lymph nodes will be enlarged and tender with acute lymphadenitis.
 
Treatment consists of (i) Rest and elevation of the part to reduce oedema.

(ii) Appropriate antibiotics preferably broad spectrum should be administered.

(iii) Failure of inflammatory swelling to subside after 48 to 72 hrs suggests that an abscess has developed.

In that case incision and drainage of the pus should be accomplished.
 
Ref: L & B 25/e, Page 37; Sabiston 18/e, Page 307; Textbook Of Surgery 5/e, Page 68

 


Q. 2

False regarding streptococcus pyogenes

 A

Causes necrotizing fascitis

 B

Beta hemolytic

 C

M. protein is virulece factor

 D

Resistant to bacitracin

Q. 2

False regarding streptococcus pyogenes

 A

Causes necrotizing fascitis

 B

Beta hemolytic

 C

M. protein is virulece factor

 D

Resistant to bacitracin

Ans. D

Explanation:

Ans. is ‘d’ i.e., Resistant to bacitracin

  • Streptococcus pyogenes is bacitracin sensitive.
  • All other options are correct.

Q. 3

Streptococcus causing rheumatic heart disease is ‑

 A

Streptococcus milleri

 B

Streptococcus mutans

 C

Streptococcus pyogenes

 D

Streptococcus equisimilis

Q. 3

Streptococcus causing rheumatic heart disease is ‑

 A

Streptococcus milleri

 B

Streptococcus mutans

 C

Streptococcus pyogenes

 D

Streptococcus equisimilis

Ans. C

Explanation:

Ans. is ‘c’ i.e., Streptococcus pyogenes 


Q. 4

Causative agent of sore throat is:  

September 2005

 A

Staphylococcus aureus

 B

Streptococcus pyogenes

 C

H. Influenzae

 D

Corynebacterium diphtheriae

Q. 4

Causative agent of sore throat is:  

September 2005

 A

Staphylococcus aureus

 B

Streptococcus pyogenes

 C

H. Influenzae

 D

Corynebacterium diphtheriae

Ans. B

Explanation:

Ans. B: Streptococcus pyogenes

The primary site of invasion of human body by streptococcus pyogenes is the throat.

Primary bacterial pathogens that account for approximately 30% of cases of pharyngitis include Streptococcus pyogenes /Group A Beta Hemolytic Streptococci (common), group C streptococci (uncommon), group G streptococci (uncommon), Neisseria gonorrhoeae (uncommon), Corynebacterium diphtheriae (rare), and Corynebacterium hemolyticum (extremely rare). Viruses are isolated in approximately 40% of cases and include rhinovirus, adenovirus, parainfluenza virus, coxsackievirus, coronavirus, echovirus, herpes simplex virus, Epstein-Barr virus (mononucleosis), and cytomegalovirus. Other probable copathogens for pharyngitis in children include Staphylococcus aureus, Haemophilus influenzae, Branhamella catarrhalis, Bacteroides fragilis, Bacteroides oralis, Bacteroides melaninogenicus, Fusobacterium species, and Peptostreptococcus species.


Q. 5

Scarlet fever is caused by

 A

Streptococcus agalactie

 B

Streptococcus pyogenes

 C

Streptococcus pneumoniae

 D

Streptococcus equisimilus

Q. 5

Scarlet fever is caused by

 A

Streptococcus agalactie

 B

Streptococcus pyogenes

 C

Streptococcus pneumoniae

 D

Streptococcus equisimilus

Ans. B

Explanation:

Ans. is ‘b’ i.e., Streptococcus pyogenes

Infections caused by streptococcus pvogenes

  1. Respiratory infections
  • Sore throat is the most common of streptocococcal disease . It may be localised as tonsillitis as in older children and adults or it may involve the pharynx more diffusely (pharyngitis) as in younger children. Otitis media


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