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Strep A Throat, Symptoms and Treatment


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Strep Throat Symptoms and Treatment

Group A streptococcus (GAS) Infections – Streptococcus Pyogenes

What is group A streptococcus (GAS)?

  • Group A streptococci (GAS) are bacteria commonly found in the throat and on the skin. GAS is often associated with relatively mild illnesses, such as “strep throat” and impetigo (blisters on the skin).
  • Strep throat is a common cause of sore throat in other kids.
  • People with strep throat should stay home from work, school, or daycare, and wait till they no longer have a fever and have taken the requires antibiotics for at least 12 hours.
  • However, the World Health Organization (WHO) reported group A streptococcal infection as the ninth leading infectious etiology of human mortality.
  • Strep A Throat Symptoms and Treatment reported several life-threatening infections in the last years.

More about Strep A Throat Symptoms and Treatment

  • Strep throat (Streptococcus pyogenes) is a gram-positive, facultative, non-spore-forming cocci that cause an array of infections that are highly contagious including acute pharyngitis, accounting for 15-30% of cases in school-aged children and 5-10% of cases in adults.
  • Moreover, this pathogen is most associated with mild localised self-resolving infections to life-threatening invasive infections in infants, children, and adults. Streptococcal pharyngitis typically resolves in 7 to 10 days.
  • However, Streptococcal pharyngitis infections have long been associat­ed with serious morbidity and mortality.
  • Patients, regardless of age, who have a positive throat culture requires antibiotics.
  • It is essential to learn how to deal with strep in Arabic and treat it to improve the life of the healthy children

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What is invasive group A streptococcal disease?

  • Streptococcus pyogenes causes a variety of infections including pharyngitis, tonsillitis, scarlet fever, cellulitis, and lymphangitis.Also, the reported incidence of severe invasive systematic group A streptococcal infections include folliculitis, osteomyelitis, endocarditis, pneumonia, and otitis infection.
  • The most severe infections linked to GAS come from invasive group A strep, known as iGAS. These infections are caused by bacteria invading other body parts, such as the lungs or bloodstream. 
  • Additionally, Streptococcus pyogenes is a β-hemolytic streptococcus belonging to Lancefield serogroup A, also known as the group A streptococci.
  • The Beta hemolytic strep is further subdivided based on reaction to Lancefield antigens – a system designed by American microbiologist Rebecca Lancefield in the 1920s.

  • Thus, Streptococci are divided into three groups by the type of hemolysis on blood agar:

    • Beta-hemolytic (complete lysis of red cells),
    • Alpha hemolytic (green hemolysis)
    • Gamma-hemolytic (no hemolysis). 

 

Strep A Throat Symptoms and Treatment

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  • Furthermore, the pathogenicity of this bacteria is due to the production of multiple toxigenic and tissue-destructive virulence factors. It facilitates the transition from a superficial to an invasive disease phenotype. These include necrotising fasciitis, myositis, toxic shock syndrome, and septicemia.

Before discussing the Strep A Throat Symptoms and Treatment, you Must Know

  • Multiple virulence factors are responsible for clinical manifestations of the S. pyogenes:
    • A bacterial capsule consists of hyaluronic acid that protects against phagocytosis.
    • Furthermore, the M protein, lipoteichoic acid, and protein F are responsible for the attachment of the bacteria to host cells. Also, the M protein is responsible for inhibiting opsonisation by binding to complement regulators and to fibrinogen.
  • Moreover, Pyogenes also produce exotoxins, like a pyrogenic (erythrogenic) toxin, which is responsible for the rash of scarlet fever and toxic shock syndrome.
  • Other virulent factors include streptokinase, streptodornase, hyaluronidase, and streptolysins, which help in the invasion of tissues.
  • In addition, the generation of human cross-reactive antibodies in response to lingering group A Streptococcus infection can result in the development of post-streptococcal autoimmune sequelae that afflict the organs, joints, and CNS. This includes acute rheumatic fever and post-streptococcal glomerulonephritis.

Sources and transmission of Strep A infection

Before mentioned Strep A Throat Symptoms and Treatment, it is important to know the source

Group A Streptococcal infection transmission can occur through:

  • Airborne droplets due to close contact with an infected person (cough and sneeze).
  • Hand contact with nasal discharge or with objects or surfaces contaminated with bacteria and skin contact with contaminated lesions.
  • Contaminated food sources.
  • Moreover, crowded places like military camps, nursing houses, and schools cause ease of transmission of the organism and result in epidemics of Strep A Throat Symptoms and Treatment

Anyone can develop group A streptococcal disease, but people who are most at risk include:

  • Children under five years of age, especially infants
  • Older people over 65 years of age
  • People with poor access to hygiene facilities
  • People with weak immune systems or suffering from chronic illness.

However, some people may carry the infection but appears asymptomatic.

Strep A Invasive Infections: Types & Symptoms 

Group A streptococcal infection can range from mild infection, like a sore throat, to severe or life-threatening conditions. Symptoms of group Streptococcal infections vary according to the infection:

Mild Strep infections include:

  • Strep throat:

The most common Strep A infection, Signs of Strep Throat is common among school-aged children and teenagers. Strep throat Symptoms may include a sore throat and tonsils, pain while swallowing, fever, muscle aches and tiredness.

 

  • Scarlet fever:

It is an infection that causes a rash, sore throat, and a high fever, which is caused by a toxin the bacteria releases into the body. Symptoms include red sore throat, swollen glands, and fever. Also, around 12 to 48 hours after infection, red blotches can appear on the skin, usually on the face, neck, underarms, or groin. Red bumps can also form on the tongue, sometimes called a ‘strawberry tongue’.

  • Skin infections:

Group A strep organisms can be responsible for certain types of skin infections, such as Impetigo is an infection that appears as sores and blisters that form near mouth and nose or on arms and legs. Cellulitis is an infection that targets deep skin tissues, areas of skin becoming red and inflamed, painful and swollen.

  • Necrotising fasciitis

is a serious skin infection that can cause deep, painful skin sores as well as fever, diarrhea or vomiting, septic shock, and organ failure.

Severe Strep infections may lead to severe complications including:

  • Bacteremia or septicemia: (systemic blood infection and invasion by bacteria).
  • Streptococcal toxic shock syndrome (STSS): STSS is another rare infection caused by group A strep bacteria. This serious illness happens when a bacterial toxin invades the body. STSS symptoms include a severe drop in blood pressure, increased heart rate, and rapid breathing or even multiorgan failure.

 

  • Post-streptococcal glomerulonephritis:

Post streptococcal infection illness that often causes swelling of legs, ankles, face, and abdomen, bloody urine, and high blood pressure.

It usually starts 10 to 14 days after the initial infection.

  • Rheumatic fever:

Rheumatic fever is an illness that occurs post pharyngeal infection caused by group A beta-hemolytic Streptococcus pyogenes infection. It is mostly seen in children aged six to fifteen.

Moreover, the strep. bacterium contains a protein similar in structure to that found in certain tissues of the body.

Thus, rheumatic fever occurs as a cross-reactivity caused by antibodies binding to the heart, brain, and joints leading to cardiac damage, polyarthritis, and chorea.

Symptoms of rheumatic fever can include:

  • Fever
  • Swollen, red tonsils.
  • Painful, tender joints (arthritis), most commonly in the knees, ankles, elbows, and wrists.
  • Muscle aches or painful, tender joints.
  • Symptoms of congestive heart failure, including chest pain, shortness of breath, fast heartbeat.
  • Chest pain and fatigue.
  • Jerky, uncontrollable body movements (called “chorea”).
  • Painless lumps (nodules) under the skin near joints (this is a rare symptom).
  • Rash that appears as pink rings with a clear center (this is a rare symptom).

Diagnosis:

  • The main test for the detection of group A β-hemolytic streptococci is throat culture, however, physicians don’t recommend it as it delays treatment.
  • Also, the pyrrolidinyl arylamidase activity (PYR) test is used to distinguish  pyogenesfrom other beta-hemolytic streptococci by testing for the presence of the enzyme pyrrolidinyl aminopeptidase. 
  • Additionally, anti-streptolysin O (ASO) and anti-DNase B (ADB) titers are used to indicate the previous streptococcal infection and can be used for the diagnosis of post-streptococcal complications.
  • Skin infections are diagnosed by taking a swab of the blisters or crust of sores and checking for the presence of bacteria.

When to concern:

  1. There is an important concern in Strep A Throat Symptoms and Treatment
  2. During the winter and spring in temperate climates, up to 20% of asymptomatic school-aged children may be Strep A carriers.
  3. Furthermore, GAS infections cause various symptoms, a child may suffer from sore throat, fever, chills, and muscle aches. Untreated strep throat or an incomplete antibiotic course can result in a rheumatic fever that causes permanent damage to the heart’s valves.
  4. Thus, seek a medical intervention in Strep A Throat Symptoms and Treatment, when the CHILD is:
  • very tired or irritable.
  • eating less than normal.
  • suffers from difficulty of breathing.
  • shows signs of dehydration.

Prevention:

  • The best way to protect from group A strep infection is to practice personal hygiene, like good hand washing for 20 seconds with soap and warm water and sanitising hands often.
  • Let’s talk about the prevention of Strep A, and  know more about the Strep A Throat Symptoms and Treatment 
  • Washing hands especially after coughing and sneezing, before and after preparing foods, and before eating.
  • Wearing a protective mask when feeling sick prevents the spread of infection.
  • Good ventilation and avoiding crowded places.
  • Be sure to cover the nose using a tissue when coughing and sneezing.
  • All wounds should be kept clean for Strep A Throat Symptoms and Treatment.
  • Following the prescribed antibiotics treatment stops the spread of infection around 24 hours from being infected and prevents post-infection illnesses.
  • Children or adults with strep throat should stay home from work, school, or nursery until 24 hours or more after taking an antibiotic. 
  • Ensure your child completes the entire course of  the required antibiotics.

Treatment 

  • A course of antibiotics is the standard treatment for Strep A infection.
  • Moreover, the duration will depend on the site of infection and the severity of Strep A Throat Symptoms and Treatment disease.
  • Infected patients requires antibiotics that may be prescribed include penicillin or cephalosporin and antibiotic ointments for skin infections.

In conclusion

  • Strep A Throat Symptoms and Treatment are extremely contagious global infections, they range from mild to severe serious illnesses.
  • Most deaths are due to invasive infections and rheumatic heart disease, especially in developing countries. 
  • Also, poor hygiene and crowding help the spread of this infection.
  • Moreover, poor compliance with treatment can result in post-infection complications. 

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