Streptococcus: Group A (Strep Pyogenes)

Your Path

  • Streptococcus: Group A (Strep Pyogenes)

Sites

  • Throat (pharyngitis, peritonsilar abscess)
  • Skin: superficial (erysipelas), impetigo, cellulitis, lymphangitis; Deeper: abscess, nec fasc)
  • Toxin medicated (toxic shock): systemic illness, sometime primary infxn site (e.g. skin) apparent
  • Kidneys (post-strep GN)
  • Pan-Carditis (acute rheumatic fever)

Symptoms

  • Skin (Cellulitis): pain/redness of infected skin area
  • Pharyngitis: acute throat pain, f, adenopathy, no cough
  • Scarlet fever: high temp, rash, palatal petechiae, throat sx
  • Deep tissue: necrotizing fasciitis w/severe illness, pain, fever
  • Toxic shock: fever, severe illness, sometime primary site of infxn (e.g. skin) apparent
  • Glomerulonephritis: 10-14d post strep infxn process; htn, fatigue, dark urine
  • Acute rheumatic fever: several weeks post pharyngitis; fever, migratory arthritis, sob/cp, skin findings, involuntary movements

Physical Exam Findings

  • Pharyngitis (strep throat): F, pharyngeal erythema, exudate, cervical adenopathy; peritonsilar abscess as complication
  • Impetigo: Honey crusted lesions, serous exudate; often on face
  • Necrotizing Fasciitis: fever, pain, edema, erythema, sometimes bullae, necrosis
  • Lymphadenitis: F, lymph nodes warm, tender, enlarged
  • Lymphangitis: red streaking along lymphatics
  • Scarlet fever: F, bright red rash, palatal petechiae
  • Rheumatic fever: F, arthritis, skin nodules, erythema marginatum, choreaform movements

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