Strep Infections

Question 1

Gram stain and shape of Strep

Answer 1

Gram positive in chains or pairs

Question 2

What are the alpha and beta hemolytic strains of strep

Answer 2

Alpha: Streptococcus pneumonaie
Beta: Group A, B, C, G

Question 3

Infections associated with Strep

Answer 3

Pharyngitis
Scarlet fever
Rheumatic heart disease
Sinusists, otitis media, mastoiditis, peritonsillar abcess, cervical lymphagitis
Endocarditis, pneumonia, empyema, nec fasc

Question 4

Diagnosis of strep

Answer 4

Rapid antigen test confirmed with cx

Question 5

What are the clinical criteria to test a patient for strep

Answer 5

Temp >38 C, tender anterior cervical lymphadenopathy, lack of cough and pharyngotonsillar exudate

Question 6

Treatment options for Strep

Answer 6

PCNs: Benxathine PCN G 1.2 mU IM, PCN VK 500mg BID x10 days, Amoxicillin 500mg BID x 10days
Cephalosporins (if PCN allergy): Cephalexin 500mg po BID 5-10days or Cefdinir 300mg po BID x5-10days
Macrolides (if PCN and Ceph allergy): Erythromycin 500mg po QID x 5 days, Azithromycin 500mg PO QD x 5 days

Question 7

Gram stain and shape of strep pneumonia

Answer 7

gram positive spheres

Question 8

What assists strep pneumonia in increasing its virulence

Answer 8

Capsular polysaccharide structure protects from phagocytosis

Question 9

Diagnosis of strep pneumonaie

Answer 9

Urinary antigen testing, lung tissue, sputum cx w/ gram stain

Question 10

Strep pneumonaie treatment

Answer 10

PCN G, vaccination
Resistance to fluroquinolone, macrolides, and PCN resistance