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    Streptococcus

    Uploaded by

    Mohsen Haleem
    This document summarizes information about the genus Streptococcus. It describes the morphology and classification of streptococci, important species that cause human infection like S. pyogenes (Group A streptococci), clinical manifestations of streptococcal infections, non-suppurative complications, treatment, and other streptococcal species such as S. agalactiae and viridans streptococci. Key points covered include characteristics of Group A streptococcal infections like pharyngitis, impetigo, necrotizing fasciitis; non-suppurative sequelae including acute rheumatic fever and glomerulonephritis; and prevention of GBS neonatal infections with intrapartum prophylaxis.

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    © All Rights Reserved
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    Streptococcus

    Uploaded by

    Mohsen Haleem
    300 views22 pages
    This document summarizes information about the genus Streptococcus. It describes the morphology and classification of streptococci, important species that cause human infection like S. pyogenes (Group A streptococci), clinical manifestations of streptococcal infections, non-suppurative complications, treatment, and other streptococcal species such as S. agalactiae and viridans streptococci. Key points covered include characteristics of Group A streptococcal infections like pharyngitis, impetigo, necrotizing fasciitis; non-suppurative sequelae including acute rheumatic fever and glomerulonephritis; and prevention of GBS neonatal infections with intrapartum prophylaxis.

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    Streptococcus

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    This document summarizes information about the genus Streptococcus. It describes the morphology and classification of streptococci, important species that cause human infection like S. pyogenes (Group A streptococci), clinical manifestations of streptococcal infections, non-suppurative complications, treatment, and other streptococcal species such as S. agalactiae and viridans streptococci. Key points covered include characteristics of Group A streptococcal infections like pharyngitis, impetigo, necrotizing fasciitis; non-suppurative sequelae including acute rheumatic fever and glomerulonephritis; and prevention of GBS neonatal infections with intrapartum prophylaxis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    300 views22 pages

    Streptococcus

    Uploaded by

    Mohsen Haleem
    This document summarizes information about the genus Streptococcus. It describes the morphology and classification of streptococci, important species that cause human infection like S. pyogenes (Group A streptococci), clinical manifestations of streptococcal infections, non-suppurative complications, treatment, and other streptococcal species such as S. agalactiae and viridans streptococci. Key points covered include characteristics of Group A streptococcal infections like pharyngitis, impetigo, necrotizing fasciitis; non-suppurative sequelae including acute rheumatic fever and glomerulonephritis; and prevention of GBS neonatal infections with intrapartum prophylaxis.

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    © All Rights Reserved
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    Streptococcus

    Streptococcus
    Description

    and Morphology
    Classification of Streptococci
    Laboratory diagnosis
    Epidemiology
    Clinical infections
    Treatment

    Description & Morphology


    Gram

    Positive Cocci arranged in chains


    except S.pneumoniae Diplococci
    All are Catalase Negative

    May be capsulated eg. S.pneumoniae

    Classification of Streptococci

    Type of Haemolysis:
    1-- hemolytic
    {S.pneumoniae & Viridans}
    2--hemolytic
    { Streptococcus group A, B, C, G, D
    & F}
    3- ( ) non- hemolytic
    { Enterococcus}

    Type of Haemolysis

    Group
    A,B,C,D,F,G

    S.Pneumo
    Viridans

    Enterococci

    Latex agglut

    Optochin

    Biochemical
    tests

    Bacitracin (S )
    GAS

    Latex agglutination

    Optochin

    Streptococci of importance in human


    infection
    Species

    S. Pyogenes
    S. Agalactiae
    S. equisimilis
    S.Milleri
    S. bovis
    S. viridans
    S. pneumoniae

    Type of
    hemolysis

    Lancefield group

    A
    B
    C
    F
    D
    -

    Streptococcus Pyogenes

    Group A Streptococci (GAS) = S. pyogenes

    Gram-positive cocci, -hemolytic, catalase


    negative, arranged in chains, bacitracine sensitive

    Carriers:
    Throat ( 10% 0f children) & Nasal carrier
    Infected skin lesions

    Streptococcus Pyogenes Clinical Infections


    Upper Respiratory tract Infections
    A- Tonsillitis / Pharyngitis
    The commonest bacterial cause of tonsillitis

    B- Scarlet fever
    Streptococcal sore throat (Children < 10 years)
    Incubation period is 2-3 days
    Generalized erythema & Strawberry tongue
    C- Acute Otitis media & Sinusitis

    Otitis medi

    tonsillitis

    Scarlet fever

    Streptococcus Pyogenes Clinical


    Infections
    Skin and Soft tissue infections
    A- Cellulitis
    Streptococcal cellulitis is a spreading
    infection bacteraemia
    B- Erysipelas
    Acute spreading skin lesion
    Marked oedema & erythema of skin
    C-Impetigo
    Primary bullous skin lesion
    Children

    Streptococcus Pyogenes Clinical


    Infections
    D-Necrotizing Fasciitis
    Infection progress rapidly
    Destroy fascia
    Systemic shock
    Young healthy & immunocompromised

    D-Myositis

    Rare & mimic necrotizing fasciitis


    Throat blood Muscle

    erysipellas
    impetigo

    cellulitis

    Necrotizing fascitis

    Streptococcus Pyogenes Clinical


    Infections
    Streptococcal toxic shock syndrome
    Acute fulminating disease
    Bacteraemia with toxaemia
    Shock with multi-organ failure
    Mortality 20-30%
    Streptococcal pyrogenic exotoxins

    Question
    List

    infections can be caused by GAS


    and S. aureus
    Cellulitis
    Erysipelas
    Impetigo
    Wound

    infection
    Toxic shock syndrome

    Streptococcus Pyogenes
    Non- Suppurative Complications
    A- Acute Rheumatic Fever (ARF)
    Throat infection 1-5 weeks earlier, children 6-15yrs
    Autoimmune phenomenon (streptococcal antigens
    to a variety of human tissue antigens)
    Pathology involve primarily heart,
    Joints & Central nervous system

    are similar

    Streptococcus Pyogenes

    Non- Suppurative Complications


    B- Acute Glomerulonephritis ( AGN)
    Post GAS throat & skin infections
    Children & young adult
    Oedema, Hypertension, Haematuria & Proteinuria

    Streptococcus Pyogenes

    Treatment
    All GAS are sensitive to penicillin

    Chemoprophylaxis
    Penicillin prophylaxis after primary attack of ARF
    No prophylaxis in case of AGN

    Case
    A 3 year old child with a heart murmur comes to your
    office and you suspect that he might have rheumatic
    fever. His parents stated that 3 weeks ago he had
    sore throat. To see if the child had a GAS infection
    the best action would be to:
    do a throat swab and Gram stain it
    do a throat swab and streak on blood agar
    do a skin test with M protein
    look for antibodies to streptolysin O (ASO)
    Look for toxic shock toxin

    Streptococcus agalactiae
    Group B streptococci ( GBS)
    Common cause of neonatal
    infections
    ( Meningitis & Septicemia)
    15-20 % of women are vaginal
    carriers
    Prevention of GBS
    neonatal infection
    Intrapartum prophylaxis
    with ampicillin

    Other Streptococci
    Group C Streptococci
    Sore throat/ tonsillitis
    Group D Streptococci (S. bovis )
    Bacteraemia & Endocarditis in
    patients with bowel carcinoma
    Group F streptococci
    Abscesses (brain, abdominal)

    Viridans streptococci
    Clinical infections
    Oral streptococci
    A-Dental caries
    B-Infective Endocarditis
    the most common cause of infective
    endocarditis
    Treatment:
    Penicillin + gentamicin for 4-6 wks

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