GABHS, Group A beta hemolytic streptococcus
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, and erysipelas and Necrotizing fasciitis
Pharyngitis: 15–30% of childhood cases and 10% of adults
Less common
Bacteremia Septic arthritis Osteomyelitis Vaginitis – vagina (more common 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.)
Severe infections:Shock, multisystem organ failure, and death.
Complications
Poststreptococcal glomerulonephritis
Streptococcal toxic shock syndrome (STSS)
Rheumatic fever
PANDAS
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 FEMALE GENITALIA/SEX - INFLAMMATION - Uterus - endometritis
Remedies
ARS, MERC
LACH, SUL, PHOS, KALI-I
Bell, Nat-m, Tub
Apis, Hep, Bry, Crot-h
Pharyngitis Throat, Pharyngitis Impetigo Skin, Impetigo Arthritis
Osteomyelitis
Ext, Inflamation, Periostitis Vaginitis Meningitis Sinusitis Pneumonia*
Arthritis
Phayngitis
Endocarditis
Meningitis
Osteomyelitis
Cellulitis
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
Common signs and symptoms include
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