Bacteria

Group A Beta-hemolytic Streptococcus

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Group A Beta-hemolytic Streptococcus, Group A Streptococcus, Streptococcus Pyogenes

  • Epidemiology
  1. In 2022, there is an increase globally of invasive Group A Streptococcus and Scarlet Fever
    1. https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429
  2. Group A Streptococcus results in 700 million infections and complicated by 500,000 deaths each year worldwide
    1. Carapetis (2005) Lancet Infect Dis 5(11): 685-94 [PubMed]
  3. Post-streptococcal complications have become uncommon in the United States
    1. Complications are more common in Sub-Sahara Africa, India, Australia, New Zealand
  • Pathophysiology
  • General
  1. Anaerobic Gram Positive Cocci
  2. Humans are only reservoir
  3. Antibiotic management of Streptococcal Pharyngitis and decreases Rheumatic Fever risk
    1. However, does not prevent Post-Streptococcal Glomerulonephritis
  4. Autoimmune complications arise from Antibody formation against streptococcal M Protein
    1. Immune complex deposition in Post-Streptococcal Glomerulonephritis
    2. Antibody directed reaction in Acute Rheumatic Fever
    3. Autoantibody cross-reaction to Basal Ganglia in Sydenham Chorea
  • Pathophysiology
  • Infections Caused by Group A Beta Hemolytic Streptococcus
  1. Streptococcal Pharyngitis
  2. Streptococcal Bacteremia (Age under 3 years)
  3. Perianal Streptococcal Cellulitis
  4. Otitis Media
  5. Acute Sinusitis
  6. Peritonsillar Abscess
  7. Bacterial Pneumonia
  8. Toxic Shock Syndrome
  9. Bacterial Meningitis
  10. Subacute Bacterial Endocarditis (SBE)
  11. Beta-Hemolytic Streptococcal Cellulitis
  12. Necrotizing Soft Tissue Infection
  13. Scarlet Fever
  • Complications
  1. Poststreptococcal Reactive Arthritis
    1. Onset 1-2 weeks after streptococcal infection
    2. Severe and prolonged Arthritis
      1. Contrast with Rheumatic Fever associated Arthritis
  2. Poststreptococcal Glomerulonephritis
  3. Childhood Acute Neuropsychiatric Symptoms (or PANDAS)
  4. Guttate Psoriasis
  5. Sydenham's Chorea
  6. Rheumatic Fever
  7. Henoch Schonlein Purpura
  • References
  1. Maness (2018) Am Fam Physician 97(8): 517-22 [PubMed]