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Infections of the Respiratory Tract
Published in Keith Struthers, Clinical Microbiology, 2017
A range of organisms cause pharyngitis (Figure 8.3). In addition to Streptococcus pyogenes, Streptococcus dysgalactiae (group C streptococcus) can also cause a streptococcal throat infection. An important virulence factor of Streptococcus pyogenes is the surface M protein, which has antiphagocytic properties. In addition, secreted extracellular proteins such as the haemolysins O and S, DNase, NADase, streptokinase and the pyrogenic toxin account for the range of diseases that this organism can cause in addition to pharyngitis (Figure 8.7). These include scarlet fever, toxic shock syndrome (TSS) and cellulitis.
Multi-resistant Enterobacter cloacae dacryocystitis and preseptal cellulitis: case and review of literature
Published in Orbit, 2023
Michael Kvopka, Ezekiel Kingston, Daniel D.H. Nguyen, Jessica Y. Tong, Hayden L. Kirk, Claudia M. Whyte, James D. Dalgliesh, Jennifer J. Danks
A 61-year-old male presented to general emergency with a 2-day history of right eye (RE) irritation, pruritis, conjunctival injection and new periorbital pain, erythema, and oedema that persisted despite topical chloramphenicol 1% treatment. RE conjunctival bacterial and viral swabs had been collected the day prior. Ophthalmic history included bilateral pseudophakia. Best-corrected visual acuity (BCVA) was 20/20 in both eyes (BE). He had no pain on extra-ocular movements and slit-lamp examination was limited due to RE periorbital oedema. Blood tests demonstrated elevated white cells (13.2 x 109/L), neutrophils (9.5 x 109/L), and c-reactive protein (25 mg/L). Orbital CT with contrast showed right preseptal soft tissue thickening and fluid with no retro-orbital involvement – consistent with preseptal cellulitis (Figure 2). Images were reviewed by the ear, nose, and throat (ENT) team who identified bilateral maxillary and ethmoid opacification and provisionally diagnosed chronic sinusitis. Previous RE conjunctival swabs returned positive for Streptococcus dysgalactiae, which was sensitive to penicillin and clindamycin, and Coliform spp. (no sensitivities); viral PCR was negative. He was treated with a single dose of intravenous (IV) flucloxacillin 2 g and discharged home with oral amoxicillin-clavulanic acid 875 mg/125 mg twice daily (BD).
Best management of patients with an acute sore throat – a critical analysis of current evidence and a consensus of experts from different countries and traditions
Published in Infectious Diseases, 2023
Ronny K. Gunnarsson, Mark Ebell, Robert Centor, Paul Little, Theo Verheij, Morten Lindbæk, Pär-Daniel Sundvall
Streptococcus dysgalactiae subsp. equisimilis is a new definition of strains including those group C and G Streptococci now considered to be potential pathogens in humans. Some strains of group C Streptococci previously considered potential pathogens in humans are not included in S. dysgalactiae subsp. equisimilis since their pathogenicity in humans has been reconsidered [14]. The key question is to what extent these bacteria are causative and to what extent they are merely a coincidental finding of a temporary commensal bacteria [23]. Patients with a sore throat harbouring S. dysgalactiae subsp. equisimilis have similar symptoms as those with GAS indicating that S. dysgalactiae subsp. equisimilis is of some importance [17]. Case-control studies, analysing the prevalence of bacteria in symptomatic patients as well as in healthy controls, conclude that S. dysgalactiae subsp. equisimilis in adolescents and adults with an apparently uncomplicated acute sore throat is of some importance (Table 1) [14]. Streptococcus dysgalactiae subsp. equisimilis is probably unimportant in children with an apparently uncomplicated acute sore throat (Table 1) [14].
Time to positivity of blood cultures in bloodstream infections with Streptococcus dysgalactiae and association with outcome
Published in Infectious Diseases, 2023
Anna Bläckberg, Katrina Lundberg, Stina Svedevall, Bo Nilson, Magnus Rasmussen
Streptococcus dysgalactiae belongs to the group of beta-haemolytic streptococci with a disease spectrum comprising milder infections such as tonsillitis and erysipelas to severe skin and soft tissue infections, necrotising soft tissue infections, infective endocarditis (IE) and sepsis [1,2]. Bloodstream infections with S. dysgalactiae frequently occurs in older persons. Bacteraemia with the pathogens tends to reoccur, often within six months after the first episode resulting in substantial morbidity and mortality [3]. S. dysgalactiae causes an acute presentation of disease which may progress into sepsis and septic shock. Prognostic and diagnostic tools to predict disease deterioration in patients with severe infections due to S. dysgalactiae are largely lacking.