Streptococcal infections

Description:

Streptococcal infections – the group of diseases including the infections caused by streptococcal flora of different types and the respiratory tracts and integuments which are shown in the form of defeat. Streptococcal infections are dangerous by tendency to development of postinfectious complications from various bodies and systems.

Reasons of streptococcal infections:

Streptococci are the whole family of microorganisms. Under a microscope they look as a chain of balls. Among this family is harmless for the person, however several types cause quite large number of dangerous diseases from food poisonings before purulent processes practically in any point of an organism.
Disease-producing influence of a streptococcus is defined by its ability to produce toxins (poisons): streptolysin has the destroying effect on blood cells and tissues of heart, эритрогенин causes expansion of small vessels and causes emergence of rash, for example at scarlet fever, leukocidin destroys leukocytes – one of elements of immune system. Besides the streptococcus emits the enzymes promoting penetration and its distribution in fabrics.

Pathogeny:

Source of an infection is the sick person, perhaps asymptomatic carriage of the activator.

The main way of transfer of a streptococcus – vozdushno drop, besides is possible a contact and household way  - through dirty hands, contaminated objects of patient care. Penetration into an organism happens through a mucous membrane of respiratory tracts (96-97%) more often, infection through the injured skin or through an umbilical wound at newborns is possible.

In the place of implementation of a streptococcus the inflammation center serous, purulent or with necrosis of the struck fabrics develops in an organism (necrotic). Emitting special enzymes, the streptococcus breaks local barriers and gets into blood and lymphatic system, causing formation of the centers of a streptococcal infection in the remote bodies (heart, a bone, etc.), an inflammation of lymph nodes. The toxins emitted by a streptococcus cause sharp rise in temperature, vomiting, a headache, consciousness disturbances (more often happens at scarlet fever, an ugly face, sepsis). We mean also a so-called allergic syndrome not less: in an organism of the patient allergic reaction to components of a cellular cover of a streptococcus during which own immune system injures kidneys, heart, joints develops. Immunity after the postponed streptococcal infection is unstable therefore the person can repeatedly have streptococcal diseases (the exception makes one of components – against the toxins produced by a streptococcus, it remains for the rest of life, providing protection against a recurrent disease with scarlet fever).

Symptoms of streptococcal infections:

Symptomatology of streptococcal infections are extremely diverse in view of a large number of probable localizations of the center of an infection, types of the activator. Besides, intensity of clinical manifestations depends on the general condition of the organism infected.
Streptococci of group A are inclined to damage of upper airways, the hearing aid, leather (streptoderma), causative agents of scarlet fever and an ugly face concern to this group.
The diseases which developed as a result of defeat by these microorganisms can be divided into primary and secondary forms.
Primary forms represent failure inflammatory infectious diseases of the bodies which became infection atriums (pharyngitis, laryngitis, quinsy, otitis, impetigo, etc.).
Secondary forms develop as a result of turning on of autoimmune and toksiko-septic mechanisms of development of an inflammation in various bodies and systems.
Rheumatism, glomerulonephritis and streptococcal vasculitis belong to secondary forms of streptococcal infections with the autoimmune mechanism of development. Toksino-infektsionny necrotic defeats of soft tissues, meta - and peritonsillar abscesses, streptococcal sepsis have character.
Rare clinical forms of streptococcal infections: necrotic inflammation of muscles and fastion, enteritis, syndrome of toxic shock, focal infectious defeats of bodies and fabrics (for example, abscess of soft tissues).
Group B streptococci in the majority cause infections in newborns though meet at any age. It is connected with preferential defeat by this activator of urinogenital ways and infection of newborns intranatalno.
Streptococcal infections of newborns are shown in the form of bacteremia (30% of cases), pneumonia (32-35%) and meningitis. In half of cases the infection is shown clinically in the first days of life.
At the same time streptococcal infections of newborns proceed extremely hard, mortality among the diseased makes about 37%. Meningitis and bacteremia can be shown later. In that case about 10-20% of the diseased perish, and at a half of survivors note development disturbances.
Streptococcal infections of group B quite often are the reason of puerperal endometritis, cystitis, adnexites at women in childbirth and complications in the postoperative period when performing Cesarean section.
Streptococcal bacteremia besides can be noted at persons with the expressed easing of immune properties of an organism (the elderly people sick with a diabetes mellitus, an immunodeficiency syndrome, malignant new growths).
Quite often against the background of the proceeding SARS streptococcal pneumonia develops. The green streptococcus can be the cause of development of endocarditises and the subsequent valve defects.
Streptococci of the mutans group cause caries.

Diagnosis:

Etiological diagnosis of a streptococcal infection of a mucous membrane of a throat and integuments demands a bacteriological research with allocation and identification of the activator. The exception can be considered scarlet fever.
As now many forms of streptococcal bacteria were taken a certain resistance to antibiotics of some groups, the careful microbiological research and implementation of the test for sensitivity to antibiotics is necessary. The diagnosis made in sufficient volume promotes the choice of effective tactics of treatment.
Express diagnosis of streptococci of group A allow to establish the activator within 15-20 minutes from the moment of capture of the analysis without allocation of true culture. However identification of presence of streptococci not always means that they are an etiological factor of pathological process, this fact can speak also about a usual carriage. Rheumatism and a glomerulonephritis are practically always characterized by increase in an antiserum capacity to streptococci about the first days of an aggravation. The antiserum capacity to extracellular antigens is defined by a neutralization test.
If necessary examination of the bodies affected with a streptococcal infection is conducted: survey of the otolaryngologist, X-ray analysis of lungs, ultrasonography of a bladder, ECG, etc.

Treatment of streptococcal infections:

Treatment of a streptococcal infection is carried out with use of antibiotics of a penicillinic row: benzylpenicillin, ampicillin, Bicillinum-3 or bitsilli-5 for the third or fourth days after an initiation of treatment penicillin. Streptococci are not capable to gain stability against penicillinic antibiotics. At an allergy to penicillin the antibiotic of an erythromycin row (erythromycin, Oleandomycinum) can be appointed. Drugs of group of streptocides (sulfadimethoxine, co-trimoxazole) and tetracyclines (tetracycline, doxycycline) are not effective and are not recommended for treatment, their use can lead to an asymptomatic carriage (the carrier will infect people around).  By the end of treatment the drugs normalizing intestinal microflora are appointed antibiotics (линекс, baktisubtit).

Removal of toxins from an organism requires plentiful drink to 3 liters of liquid a day (tea, a fruit drink, fruit juice or just water). With the medical and fortifying purpose accept the vitamin C having ability to strengthen walls of blood vessels and to participate in removal of toxins.
The combined drugs with paracetamol like Coldrex, терафлю it is possible to use, but it is short-term as at their use there can be a visibility of wellbeing that serves as a cause of failure from treatment and emergence of complications.

Drugs for rinsing of a throat are not capable to influence not only the streptococcus which is in depth of fabrics but also surfaces. Therefore rinsing is applied rather in hygienic, than in the medical purposes. Rinsing is more preferable, than pastils to a rassasyvaniye as in the first case the activator is washed away and removed outside, and in the second is swallowed.
The diet of the sick person has to be digestible (the organism should not spend excess forces for splitting of food), with enough vitamins.