Strep

Question 1

Based on this result, is this Staphylococci or Streptococci?

Answer 1

Staphylococci

Question 2

Thoughts?

Answer 2

Acute pharyngitis

S. pyogenes

Question 3

What is this?

Answer 3

Impetigo (via S. pyogenes)

–Associated with trauma / insect bites
–Pustule with yellow crust
–Appears on face or extremities

Question 4

What strep infection are we looking at?

Answer 4

Erysipelas (S. pyogenes)

–Speading erythema with well demarcated edge on the face
–Fever and lymphadenopathy
–Lesions often on face and often with accompanying steptococcal pharyngitis

Question 5

What is this?

Answer 5

Erysipelas (S. pyogenes) of the leg

Question 6

This is a symptom of

Answer 6

Scarlet fever (S. pyogenes)

Question 7

What is this?

Answer 7

Necrotizing Fasciitis

–Strep infection that occurs deep in the subcutaneous tissues
–Spreads along the fascial planes
–Extensive destruction of the muscle and fat
–“flesh eating” bacteria
–Systemic toxicity, mortality exceeds 50%

Question 8

–multi-system organ failure (heart, respiratory tract, kidney)
–SPE toxins are similar to Staph aureus TSST-1
–Unlike patients with staph toxic shock, cultures are usually positive for group A strep

Answer 8

Toxic Shock-like Syndrome

Question 9

–Seen in women following delivery or abortion

• S. pyogenes
  –Organisms colonizing genital tract or from obstetrical personnel invade the upper genital tract causing endometritis, lymphangitis, bacteremia, necrotizing fasciitis, and streptococcal toxic shock syndrome

Answer 9

Puerperal Sepsis

Question 10

Name 2 post-streptococcal sequelae

Answer 10

1. Rheumatic fever
2. Acute glomerulonephritis

Question 11

What are we looking at here:
•Capsular polysaccharide
•Lipoteichoic acid
•Hemolysins
–Streptolysin S (oxygen stable, non-antigenic)
–Streptolysin O (oxygen labile, ASO antibodies)
•Streptokinase
•Hyaluronidase
•Nucleases
•C5a peptidase

Answer 11

S. pyogenes virulence factors

Question 12

Name a complication of strep throat, displaying:

1. sore throat
2. strawberry tongue
3. fever

Answer 12

Scarlet fever

Question 13

Necrotizing fasciitis infects what layer of tissue?

Answer 13

Subcutaneous tissue

Question 14

Heart murmer following strep through suggests

Answer 14

Rheumatic fever (sequelae)