GABHS, Group A beta hemolytic streptococcus

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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

  • (Pharyngitis): 15–30% of childhood cases and 10% of adults

Less common

(*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

Research

Myositis: Streptococcal myositis is a rare, often fatal, acute infection of the muscle, caused by an invasive group A beta-haemolytic streptococcus. It is characterised by muscle necrosis without abscess formation, and, in contrast to necrotising fasciitis, does not primarily affect the subcutaneous tissue or skin.

Ref: Dalal M, Sterne G, Murray DS. Streptococcal myositis: a lesson. Br J Plast Surg. 2002 Dec;55(8):682-4. doi: 10.1054/bjps.2002.3953. PMID: 12550125.

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


Related disease

Sydenham's chorea

PANDAS

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