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Bacteria
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Many bacteria which cause extracellular infections are encapsulated. The capsules block complement activation by the alternative pathway and thereby prevent phagocytosis. Antibody produced during the inducible response binds to the capsular material, bringing about complement activation and phagocytosis. Bacteria producing extracellular infections usually lack mechanisms to resist killing once phagocytized. The pneumococci, streptococci, and staphylococci are examples of such bacteria. Toxins, if produced, are neutralized by antibody.
Respiratory Infections
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Pharyngitis is mostly caused by viruses (adenovirus and rhinovirus) but also by bacteria (Group A streptococcus). Differential diagnosis includes epiglottitis and retropharyngeal abscess (fever, chills, voice change, dysphagia, neck stiffness and feeling of lump in throat). Untreated Group A streptococcus can cause rheumatic fever, post-streptococcal glomerulonephritis, toxic shock and abscess. Consider gonococcal infection if risk factors are present. Symptoms include fever, malaise, hoarse voice, sore throat and myalgia. Treatment is supportive for viral infections, which should resolve in up to 10 days; if a bacterial infection is suspected, for example, streptococcal, give 250–500 mg penicillin V four times a day orally for 10 days in those without penicillin allergy. Avoid amoxicillin in suspected EBV, as it leads to rash.
Disease prevention and screening in public health
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Martin C.S. Wong, Junjie Huang, Kevin Law, Hanyue Ding, Yun-yang Deng
Pneumococcal infection is caused by Streptococcus pneumonia, which can induce ear infection, sinus infection, meningitis or even bacteraemia. Like influenza, the pneumococcal bacteria is usually spread by respiratory secretions from infected people. Pneumococcal vaccination is recommended in the prevention of many types of pneumococcal bacterial infections. According to a recent systematic review of cost-effectiveness research, influenza vaccination was assessed to save 56% of health care cost, and 31% for pneumococcal vaccination (Leidner et al., 2019).
PANDAS – a rare but severe disorder associated with streptococcal infections; Awareness is needed
Published in Acta Oto-Laryngologica Case Reports, 2023
Karin Frånlund, Charbél Talani
Treatment of PANDAS must address both physical and psychiatric symptoms. Cognitive behavioural therapy is the primary evidence-based therapy for OCD, supplemented with a small dose of selective serotonin reuptake inhibitors (SSRIs) when indicated [6]. Treatment of the streptococcal infection is often post-fiftum but may include amoxicillin, penicillin, azithromycin and cephalosporins. The evidence for using antibiotics for PANS and PANDAS is inconclusive, but it is assumed that certain anti-streptococcal antibiotics may have a neuroprotective effect [3,7]. Supplemental treatments for PANDAS include tonsillectomy to prevent further streptococcal infections. To suppress the immune system and reduce OCD symptoms, corticosteroids, therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIG) or anti-CD20 monoclonal antibodies (rituximab) have been given [8].
Thyroid storm secondary to acute Streptococcus pyogenes pharyngitis
Published in Baylor University Medical Center Proceedings, 2022
Valeria Hanson, Subaina Naeem Khalid, Glenn Ratmeyer, Abu Baker Sheikh
A 24-year-old healthy woman presented with 2 days of palpitations, chest tightness, a sore throat, dizziness, nausea, and subjective fevers. Upon arrival, she had supraventricular tachycardia with a heart rate of 188 beats/min. She received adenosine 6 mg with no response and another 12 mg with improvement of her heart rate to the 140s. Following adenosine conversion, she was transferred to our hospital. At presentation, her tachycardia in the 140s persisted with stable blood pressure. Physical exam revealed tender cervical lymphadenopathy with a grossly erythematous, purulent posterior oropharynx and nontender goiter and tremors. Laboratory evaluation showed an undetectably low thyroid-stimulating hormone level of <0.007 μIU/mL (reference range 0.36–3.74) and increased free T4 of >8 ng/dL (reference range 0.7–1.6). Antithyroglobulin antibody, thyroid peroxidase antibody, and total T3 were all within normal limits. A rapid antigen test for group A Streptococcus by DNA probe was positive. She had slightly elevated liver function tests and a brain natriuretic peptide level of 2026 pg/mL. An echocardiogram was negative for cardiomyopathy and heart failure.
Unilateral Acute Idiopathic Maculopathy Associated with Streptococcal Pharyngitis, A Case Report
Published in Ocular Immunology and Inflammation, 2022
Clare L. Shute, Usha Chakravarthy, Clara E. McAvoy
UAIM was first formally recognized in 1991, and since then, research has reported a broadening spectrum of disease.1 Etiology is still not fully understood but increasing reports have established a potential connection with viral infection including the coxsackievirus.2,5,6 One recent case report by Dompieri et al. has linked UAIM to yellow fever but, to our knowledge, no report has associated UAIM with streptococcal infection.7 ASOT and ADB antibodies are the most common serological tests used in practice for GAS.10,11 ADB antibodies are more specific for GAS infection than ASOT so when used together they provide a more robust serological diagnosis of recent GAS and improve its sensitivity.10 ASOT levels typically increase within 7–10 days of acute infection with peak response 2–3 weeks after and a plateau for 3–6 months which we saw in this patient.10,11 ADB antibodies rise around 2 weeks following infection and peak at 6–8 weeks.10 A number of immune-mediated complications in relation to streptococcal infection have been well documented in the literature including rheumatic fever, erythema nodosum, reactive arthritis, and glomerulonephritis.8,9 Post-streptococcal uveitis is also known to be an auto-immune condition related to acute streptococcal infection with anterior, intermediate, and pan-uveitis all reported in the literature.8,9,13 To date, an inflammatory maculopathy has not been reported on this spectrum.