GABHS, Group A beta hemolytic streptococcus: Difference between revisions
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===Clinic=== | ===Clinic=== | ||
Group A β-hemolytic streptococcus can cause infections of the throat and skin. These may vary from very mild conditions to severe, life-threatening diseases due to host immune function stability. | * Group A β-hemolytic streptococcus can cause infections of the throat and skin. | ||
* These may vary from very mild conditions to severe, life-threatening diseases due to host immune function stability. | |||
====Most common==== | ====Most common==== | ||
Impetigo | * Impetigo / Cellulitis / Erysipelas / Necrotizing fasciitis / Lymphangitis | ||
* Pharyngitis: 15–30% of childhood cases and 10% of adults | |||
Pharyngitis: 15–30% of childhood cases and 10% of adults | |||
====Less common==== | ====Less common==== | ||
Bacteremia | * Bacteremia / Severe infections /Shock / Multisystem organ failure | ||
Septic arthritis | * Septic arthritis / Osteomyelitis | ||
Osteomyelitis | * Vaginitis( Esp in pre-pubescent girls) | ||
Vaginitis | * Meningitis | ||
Meningitis | * Sinusitis | ||
Sinusitis | * Pneumonia (Pulmonary alveolus) | ||
Pneumonia | |||
(*Note that meningitis, sinusitis and pneumonia can all be caused by Group A Strep, but are much more commonly associated with Streptococcus pneumoniae and should not be confused.) | (*Note that meningitis, sinusitis and pneumonia can all be caused by Group A Strep, but are much more commonly associated with Streptococcus pneumoniae and should not be confused.) | ||
===Complications=== | ===Complications=== | ||
Poststreptococcal glomerulonephritis | * Poststreptococcal glomerulonephritis | ||
Streptococcal toxic shock syndrome (STSS) | * Streptococcal toxic shock syndrome (STSS) | ||
Rheumatic fever | * [[Rheumatic fever]] | ||
PANDAS | * [[PANDAS]] | ||
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===Rubrics=== | ===Rubrics=== | ||
CHEST - HEART; complaints of the - endocarditis | * CHEST - HEART; complaints of the - endocarditis | ||
THROAT - INFLAMMATION - Tonsils | * THROAT - INFLAMMATION - Tonsils | ||
THROAT - INFLAMMATION - Pharynx | * THROAT - INFLAMMATION - Pharynx | ||
CHEST - INFLAMMATION - Lungs | * CHEST - INFLAMMATION - Lungs | ||
EAR - INFLAMMATION - Media | * EAR - INFLAMMATION - Media | ||
CHEST - INFLAMMATION - Heart - Endocardium | * CHEST - INFLAMMATION - Heart - Endocardium | ||
SKIN - ERUPTIONS - impetigo | * SKIN - ERUPTIONS - impetigo | ||
GENERALS - INFLAMMATION - cellulitis | * GENERALS - INFLAMMATION - cellulitis | ||
SKIN - ERYSIPELAS | * SKIN - ERYSIPELAS | ||
GENERALS - INFLAMMATION - Lymphatic vessels | * GENERALS - INFLAMMATION - Lymphatic vessels | ||
GENERALS - SEPTICEMIA, blood poisoning | * GENERALS - SEPTICEMIA, blood poisoning | ||
GENERALS - INFLAMMATION - Muscles; of | * GENERALS - INFLAMMATION - Muscles; of | ||
HEAD - INFLAMMATION - Meninges | * HEAD - INFLAMMATION - Meninges | ||
* GENERALS - CHOREA | |||
* FEMALE GENITALIA/SEX - INFLAMMATION - Uterus | |||
* GENERALS - INFLAMMATION - Bones; of | |||
* GENERALS - INFLAMMATION - Joints; of | |||
* KIDNEYS - INFLAMMATION | |||
Remedies | ===Remedies=== | ||
ARS, MERC | * ARS, MERC | ||
LACH, SUL, PHOS, KALI-I | * LACH, SUL, PHOS, KALI-I | ||
Bell, Nat-m, Tub | * Bell, Nat-m, Tub | ||
Apis, Hep, Bry, Crot-h | * Apis, Hep, Bry, Crot-h | ||
===Special feature=== | ===Special feature=== | ||
====GABHS Arthritis==== | ====GABHS Arthritis==== | ||
GBS had now become the most common pathogen for bacterial septic arthritis (37.7%), while Staphylococcus aureus was the second most common causative pathogen (23.4%). | * GBS had now become the most common pathogen for bacterial septic arthritis (37.7%), while Staphylococcus aureus was the second most common causative pathogen (23.4%). | ||
Unique clinical characteristics are | * Unique clinical characteristics are | ||
More number of joint involvements which were more likely (70%) to be oligo-polyarthritis. (Oligoarthritis is defined as arthritis affecting 2 to 4 joints during the first six months of disease.)The majority of patients in other bacterial septic arthritis in our study were affected in one joint as monoarthritis. | * More number of joint involvements which were more likely (70%) to be oligo-polyarthritis. (Oligoarthritis is defined as arthritis affecting 2 to 4 joints during the first six months of disease.)The majority of patients in other bacterial septic arthritis in our study were affected in one joint as monoarthritis. | ||
Knee is the most commonly affected joint in both groups. | * Knee is the most commonly affected joint in both groups. | ||
Upper extremities and axial joint involvements were more common in GBS septic arthritis than other bacterial septic arthritis. | Upper extremities and axial joint involvements were more common in GBS septic arthritis than other bacterial septic arthritis. | ||
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====GABHS Pharyngitis==== | ====GABHS Pharyngitis==== | ||
Most common features are | |||
* Sore throat | |||
* Temperature greater than 100.4°F (38°C) | |||
Sore throat | * Tonsillar exudates | ||
* Cervical adenopathy | |||
Temperature greater than 100.4°F (38°C) | |||
Tonsillar exudates | |||
Cervical adenopathy | |||
====Lymphangitis==== | ====Lymphangitis==== | ||
Lymphangitis is inflammation of the lymphatic channels that occur as a result of infection at a site distal to the channel and may spread within hours. Group A beta-haemolytic streptococci are the most common causes of bacterial lymphangitis and, in severe cases, can lead to bacteraemia, sepsis and death | * Lymphangitis is inflammation of the lymphatic channels that occur as a result of infection at a site distal to the channel and may spread within hours. | ||
* Group A beta-haemolytic streptococci are the most common causes of bacterial lymphangitis and, in severe cases, can lead to bacteraemia, sepsis and death | |||
Ref: Yamamoto LG. Treatment of skin and soft tissue infections. Pediatr Emerg Care 2017;33:49–55. Review doi:10.1097/PEC.0000000000001001 | Ref: Yamamoto LG. Treatment of skin and soft tissue infections. Pediatr Emerg Care 2017;33:49–55. Review doi:10.1097/PEC.0000000000001001 | ||
Revision as of 06:08, 23 March 2023
Clinic
- Group A β-hemolytic streptococcus can cause infections of the throat and skin.
- These may vary from very mild conditions to severe, life-threatening diseases due to host immune function stability.
Most common
- Impetigo / Cellulitis / Erysipelas / Necrotizing fasciitis / Lymphangitis
- Pharyngitis: 15–30% of childhood cases and 10% of adults
Less common
- Bacteremia / Severe infections /Shock / Multisystem organ failure
- Septic arthritis / Osteomyelitis
- Vaginitis( Esp in pre-pubescent girls)
- Meningitis
- Sinusitis
- Pneumonia (Pulmonary alveolus)
(*Note that meningitis, sinusitis and pneumonia can all be caused by Group A Strep, but are much more commonly associated with Streptococcus pneumoniae and should not be confused.)
Complications
- Poststreptococcal glomerulonephritis
- Streptococcal toxic shock syndrome (STSS)
Rubrics
- CHEST - HEART; complaints of the - endocarditis
- THROAT - INFLAMMATION - Tonsils
- THROAT - INFLAMMATION - Pharynx
- CHEST - INFLAMMATION - Lungs
- EAR - INFLAMMATION - Media
- CHEST - INFLAMMATION - Heart - Endocardium
- SKIN - ERUPTIONS - impetigo
- GENERALS - INFLAMMATION - cellulitis
- SKIN - ERYSIPELAS
- GENERALS - INFLAMMATION - Lymphatic vessels
- GENERALS - SEPTICEMIA, blood poisoning
- GENERALS - INFLAMMATION - Muscles; of
- HEAD - INFLAMMATION - Meninges
- GENERALS - CHOREA
- FEMALE GENITALIA/SEX - INFLAMMATION - Uterus
- GENERALS - INFLAMMATION - Bones; of
- GENERALS - INFLAMMATION - Joints; of
- KIDNEYS - INFLAMMATION
Remedies
- ARS, MERC
- LACH, SUL, PHOS, KALI-I
- Bell, Nat-m, Tub
- Apis, Hep, Bry, Crot-h
Special feature
GABHS Arthritis
- GBS had now become the most common pathogen for bacterial septic arthritis (37.7%), while Staphylococcus aureus was the second most common causative pathogen (23.4%).
- Unique clinical characteristics are
- More number of joint involvements which were more likely (70%) to be oligo-polyarthritis. (Oligoarthritis is defined as arthritis affecting 2 to 4 joints during the first six months of disease.)The majority of patients in other bacterial septic arthritis in our study were affected in one joint as monoarthritis.
- Knee is the most commonly affected joint in both groups.
Upper extremities and axial joint involvements were more common in GBS septic arthritis than other bacterial septic arthritis.
Tenosynovitis is extremely common in GBS septic arthritis (39.1%) which has seldomly presented before in other bacterial septic arthritis (2.1%).
CNS and ocular infections were commonly found in GBS septic arthritis more than other bacterial septic arthritis
GABHS Pharyngitis
Most common features are
- Sore throat
- Temperature greater than 100.4°F (38°C)
- Tonsillar exudates
- Cervical adenopathy
Lymphangitis
- Lymphangitis is inflammation of the lymphatic channels that occur as a result of infection at a site distal to the channel and may spread within hours.
- Group A beta-haemolytic streptococci are the most common causes of bacterial lymphangitis and, in severe cases, can lead to bacteraemia, sepsis and death
Ref: Yamamoto LG. Treatment of skin and soft tissue infections. Pediatr Emerg Care 2017;33:49–55. Review doi:10.1097/PEC.0000000000001001