Complications and treatment of streptococcal infections

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the most common streptococcal infections include:

  • streptococcal tonsillopharyngitis
  • scarlet fever
  • streptococcal skin infections (erysipelas, impetigo)

Complications of tonsillopharyngitis and scarlet fever[edit | edit source]

  • colliquative necrosis of submandibular node
  • retrotonsillar, peritonsillar abscess
  • otitis, mastoiditis, sinusitis
  • rarely - bacteremia, metastatic foci - purulent arthritis, endocarditis, meningitis, brain abscess, osteomyelitis
  • without therapy - the risk of late complications - rheumatic fever or glomerulonephritis

Complications of streptococcal skin infections[edit | edit source]

Rheumatic fever[edit | edit source]

  • acute immunological multisystemic inflammation
  • most often after an infection caused by streptococcus of group A
  • 1-4 weeks after infection (about 3% infected)
  • often affects the heart (carditis) - chronic changes of the valves
  • pathogenesis: hypersensitivity reactions, Ig against M-protein of streptococci cross-react with glycoproteins of the heart muscle, joints, etc.
  • the course of the original infection may be inapparent
  • often relapses

Diagnosis[edit | edit source]

Jones criteria:

  • streptococcal infection in the anamnesis
  • the presence of at least two main symptoms, or one main and two secondary:
Main symptoms:
  1. migrating polyarthritis
  2. carditis
  3. erythema nodosum (subcutaneous nodules)
  4. erythema marginatum
  5. chorea minor (neurological disorder - unconscious untargeted rapid movements), or also chorea infectiosa rheumatica, Sydenham's chorea, St. Vitus Dance
Secondary symptoms:
  • non-specific: fever, joint pain, increased FW and CRP, prolonged P-R interval on the ECG, increased ASLO titer (ie positive ASLO), rheumatic fever in the anamnesis

Principles of treatment of infections caused by Streptococcus pyogenes[edit | edit source]

  • Tonsilopharyngitis and scarlet fever: penicillin
  • Erysipelas: penicillin
  • Impetigo: lokální – mupirocin, framykoin, permanganate solution
  • Rheumatic fever: antirheumatics, prevention of recurrences of acute streptococcal infection

Prevention of late consequences: proper treatment of streptococcal diseases.

Links[edit | edit source]

Related articles[edit | edit source]

Sources[edit | edit source]

  • HAVLÍK, Jiří, et al. Infektologie. 2. vydání. Praha : Avicenum, 1990. 393 s. ISBN 80-201-0062-8.
  • LOBOVSKÁ, Alena. Infekční nemoci. 1. vydání. Praha : Karolinum, 2001. 263 s. ISBN 80-246-0116-8.
  • BENEŠ, Jiří. Studijní materiály [online]. [cit. 12.03.2010]. <>.