II. Epidemiology

  1. In 2022, there is an increase globally of invasive Group A Streptococcus and Scarlet Fever
    1. https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429
  2. Group A Streptococcus results in 700 million infections and complicated by 500,000 deaths each year worldwide
    1. Carapetis (2005) Lancet Infect Dis 5(11): 685-94 [PubMed]
  3. Post-streptococcal complications have become uncommon in the United States
    1. Complications are more common in Sub-Sahara Africa, India, Australia, New Zealand

III. Pathophysiology: General

  1. Anaerobic Gram Positive Cocci
  2. Humans are only reservoir
  3. Antibiotic management of Streptococcal Pharyngitis and decreases Rheumatic Fever risk
    1. However, does not prevent Post-Streptococcal Glomerulonephritis
  4. Autoimmune complications arise from Antibody formation against streptococcal M Protein
    1. Immune complex deposition in Post-Streptococcal Glomerulonephritis
    2. Antibody directed reaction in Acute Rheumatic Fever
    3. Autoantibody cross-reaction to Basal Ganglia in Sydenham Chorea

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