STREPTOCOCCUS Flashcards by Jamaira Belmes

catalase (-)
alpha hemolytic
optochin sensitive

Streptococcus pneumoniae

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catalase (-)
alpha hemolytic
optochin resistant

Viridans streptococci

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catalase (-)
beta hemolytic
bacitracin sensitive

Streptococcus pyogenes

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catalase (-)
beta hemolytic
bacitracin resistant

Streptococcus agalactiae

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catalase (-)

gamma hemolytic

group D streptococci

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Produces SCARLET FEVER

Erythrogenic toxin

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Highly antigenic

Causes AB formation

Streptolysin O (oxygen labile)

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Superantigen similar to TSST

Pyrogenic Exotoxin A

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Protease that rapidly destroys tissue

Exotoxin B

Responsible for necrotizing fasciitis

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Document antecedent PHARYNGITIS

anti-streptolysin (ASO)

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Document antecedent SKIN INFECTIONS

anti-DNAse B

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Antibodies decrease efficacy of streptokinase in managing MI

anti-streptokinase

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Skin and Soft Tissue Infections caused by Streptococcus pyogenes

Impetigo contagiosa
Erysipelas - superficial
Cellulitis - facilitated by HYALURONIDASE (spreading factor)
Necrotizing fasciitis - facilitated by exotoxin B; Fournier’s gangrene

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MC bacterial cause of sore throat

Streptococcus pyogenes

inflammation, exudate, fever, leukocytosis and tender CLAD

PYOGENIC COMPLICATIONS: peritonsillar and retropharyngeal (Quincy) abscess, otitis, sinusitis, meningitis

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Due to ERYTHROGENIC TOXIN

fever, strawberry tongue, centrifugal rash (sandpaper like), PASTIA LINES, desquamation

Scarlet Fever

-postpharyngitic

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Similar but milder than S. aureus

Due to PYROGENIC EXOTOXIN A

RECOGNIZABLE SITE of pyogenic inflammation

blood cultures (+)

Streptococcal Toxic Shock Syndrome

Cross reacting antibodies to M proteins and antigens of joint, heart and brain tissue

Acute Rheumatic Fever
-postpharyngitic

JONES CRITERIA

pancarditis
erythema marginatum
chorea (sydenham)
carditis (pancarditis)
subcutaneous nodules

M protein incites immune complex deposition on the GBM

hypertension, periorbital edema, HEMATURIA

Glomerulonephritis

-post impetigo (M12 type) or postpharyngitic

8/M presents w/ fever, migrating joint pains in the knees and elbows, has raised erythematous serpentine-like lesions on his back

Patients clinical presentation is most likely due to which pathophysiology mechanism?

Cross-reaction of antibodies to bacterial antigens w/ self antigens leading to cytotoxicity

MCC of NEONATAL pneumonia, sepsis and meningitis

Streptococcus agalactiae (Group B Streptococci)

PREDISPOSING FACTORS:

intrapartum fever T>38 C
PROM (>18h)
vaginal colonization
complement deficiency

All pregnant women should be screened for GBS colonization at

35-37 weeks AOG

chemoprophylaxis - IV Penicillin or Ampicillin 4 hrs prior to delivery

Major cause of ADULT PNEUMONIA

MCC of otitis media

MCC of ADULT MENINGITIS

Streptococcus pneumoniae

lancet shaped
encapsulated

Quellung reaction

Capsular Antigen Swelling Test

POSITIVE
-(+) capsular swelling when mixed with a small amt of antiserum and methylene blue

Pathogenesis (Streptococcus pneumoniae)

CAPSULE - retards phagocytosis

IgA PROTEASE - for colonization

C-SUBSTANCE - reacts w/ CRP

Responsible for the formation of DENTAL CARIES

S. mutans - can produce BIOFILM

Responsible for SUBACUTE BACTERIAL ENDOCARDITIS (SBE) MCC of subacute and native valve endocarditis

S. sanguis

Responsible for BRAIN ABSCESSES

S. intermedius

Pathogenesis (Viridans streptococci)

glycocalyx enhances adhesion to DAMAGED HEART VALVES | protected from host defenses w/n VEGETATIONS

While testing various strains of Streptococcus pneumoniae, a researcher discovers that a certain strain of this bacteria is unable to cause disease in mice when deposited in their lungs. What physiological test would most likely to deviate from normal in this strain of bacteria as opposed to a typical strain?

Quellung Reaction

34/M, heroin user, presents w/ a 3 day hx of fever T>39, chest pain, "pinching" in character, nausea, vomiting. Troponins are low. CKMB negative. ECG shows sinus tachycardia. Blood culture on 2 sites were positive. Past History: Tricuspid valve repair in 2003. What is the most likely diagnosis?

Acute Endocarditis ER na ER ang itsurahan Subacute Endorcarditis - gradual progression - ndi pang ER baks

Hydrolyzes esculin in bile-esculin agar (BEA) | positive PYR test

Group D Streptococci E. faecalis - can GROW in 6.5% NaCl S. bovis - CANNOT grow in 6.5% NaCl

Infective Endocarditis

Enterococcus faecalis PREDISPOSITION: GIT surgery

Marantic Endocarditis | -sterile form of endocarditis

Streptococcus bovis | -risk factor in developing CANCER

Cefalexin may be useful to treat which infection a. Enterococcal endocarditis b. Listeria meningitis c. MRSA pneumonia d. Hidradenitis suppurativa e. All of the above

Hidradenitis suppurativa NONE of the Cephalosporins are active against the ff: Enterococci Listeria monocytogenes MRSA

34/M, heroin user, presents w/ a 3 day hx of fever T>39, chest pain, "pinching" in character, nausea, vomiting. Emergency appendectomy was done. Troponins are low. CKMB negative. ECG shows sinus tachycardia. Blood culture on 2 sites were positive. (+) bacterial vegetations on tricuspid area are seen in TEE. What is the most likely diagnosis?

Enterococcus spp

34/M, heroin user, presents w/ sudden onset of fever T>39, vague abdominal pain, nausea and vomiting. Emergency laparotomy was done. Diagnosis of COLON CANCER was noted. Troponins are low. CKMB negative. ECG shows sinus tachycardia. Blood culture on 2 sites were positive. (+) STERILE vegetations on tricuspid area are seen in TEE. What is the most likely diagnosis?

Streptococcus bovis