II. Epidemiology
- In 2022, there is an increase globally of invasive Group A Streptococcus and Scarlet Fever
- Group A Streptococcus results in 700 million infections and complicated by 500,000 deaths each year worldwide
- Post-streptococcal complications have become uncommon in the United States
- Complications are more common in Sub-Sahara Africa, India, Australia, New Zealand
III. Pathophysiology: General
- Anaerobic Gram Positive Cocci
- Humans are only reservoir
-
Antibiotic management of Streptococcal Pharyngitis and decreases Rheumatic Fever risk
- However, does not prevent Post-Streptococcal Glomerulonephritis
- Autoimmune complications arise from Antibody formation against streptococcal M Protein
- Immune complex deposition in Post-Streptococcal Glomerulonephritis
- Antibody directed reaction in Acute Rheumatic Fever
- Autoantibody cross-reaction to Basal Ganglia in Sydenham Chorea
IV. Pathophysiology: Infections Caused by Group A Beta Hemolytic Streptococcus
- Streptococcal Pharyngitis
- Streptococcal Bacteremia (Age under 3 years)
- Perianal Streptococcal Cellulitis
- Otitis Media
- Acute Sinusitis
- Peritonsillar Abscess
- Bacterial Pneumonia
- Toxic Shock Syndrome
- Bacterial Meningitis
- Subacute Bacterial Endocarditis (SBE)
- Beta-Hemolytic Streptococcal Cellulitis
- Necrotizing Soft Tissue Infection
- Scarlet Fever
V. Complications
-
Poststreptococcal Reactive Arthritis
- Onset 1-2 weeks after streptococcal infection
- Severe and prolonged Arthritis
- Contrast with Rheumatic Fever associated Arthritis
- Poststreptococcal Glomerulonephritis
- Childhood Acute Neuropsychiatric Symptoms (or PANDAS)
- Guttate Psoriasis
- Sydenham's Chorea
- Rheumatic Fever
- Henoch Schonlein Purpura