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Chronic Pharyngeal Carriage of Streptococcus pyogenes

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1. Chronic Pharyngeal Carriage of Streptococcus pyogenes

Chronic Pharyngeal Carriage of Streptococcus pyogenes Chronic Pharyngeal Carriage of Streptococcus pyogenes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse (...) Cancer Administration 4 Chronic Pharyngeal Carriage of Streptococcus pyogenes Chronic Pharyngeal Carriage of Streptococcus pyogenes Aka: Chronic Pharyngeal Carriage of Streptococcus pyogenes , Group A Streptococcus Pharyngeal Carrier , GAS Pharyngeal Carrier From Related Chapters II. Signs Recurrent episodes GAS diagnosed with every new cold presumed due to non-GAS cause III. Diagnosis (Test when patient is well and asymptomatic) Streptococcal titer (ASO) Obtain baseline value Repeat in 4-6 weeks IV

2018 FP Notebook

2. Chronic Pharyngeal Carriage of Streptococcus pyogenes

Chronic Pharyngeal Carriage of Streptococcus pyogenes Chronic Pharyngeal Carriage of Streptococcus pyogenes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse (...) Cancer Administration 4 Chronic Pharyngeal Carriage of Streptococcus pyogenes Chronic Pharyngeal Carriage of Streptococcus pyogenes Aka: Chronic Pharyngeal Carriage of Streptococcus pyogenes , Group A Streptococcus Pharyngeal Carrier , GAS Pharyngeal Carrier From Related Chapters II. Signs Recurrent episodes GAS diagnosed with every new cold presumed due to non-GAS cause III. Diagnosis (Test when patient is well and asymptomatic) Streptococcal titer (ASO) Obtain baseline value Repeat in 4-6 weeks IV

2015 FP Notebook

3. Pharyngitis

version of this guideline performed in June, 2005. A search for literature published since that time was performed. The search on Medline was conducted prospectively for literature published from 6/1/05 to 3/30/11. One set of searches used the major keywords of: GAS pharyngitis (streptococcal infections, streptococcus pyogenes, pharyngitis, pharynx), strep throat; human; English; guidelines, controlled trials, cohort studies. Within these major keywords, specific searches were performed (...) prior to discarding.) However, a positive throat culture may reflect chronic colonization by GAS; another pathogen may be the actual cause of the acute illness. Quantitation of GAS from the throat swab cannot be used to differentiate carriage from infection because sparse growth may be associated with true infection. GAS antigen screen. Most current GAS antigen screens use a rapid immunoassay method (usually EIA technique) for determining the presence of GAS in a throat swab. Results should

2013 University of Michigan Health System

4. Streptococcal pharyngitis

the throat Note the , or small red spots, on the . This is an uncommon but highly finding in streptococcal pharyngitis. A set of large tonsils in the back of the throat, covered in white exudate. A culture positive case of streptococcal pharyngitis with typical tonsillar exudate in an 8-year-old. Cause Strep throat is caused by (GAS or S. pyogenes ). Other bacteria such as and may also cause . It is spread by direct, close contact with an infected person; thus crowding, as may be found in the military (...) lessen in time regardless of measures taken. Recurrent episodes of pharyngitis which test positive for GAS may also represent a person who is a chronic carrier of GAS who is getting recurrent viral infections. Treating people who have been exposed but who are without symptoms is not recommended. Treating people who are carriers of GAS is not recommended as the risk of spread and complications is low. Treatment Untreated streptococcal pharyngitis usually resolves within a few days. Treatment

2012 Wikipedia

5. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

broths unless the patient has been on antifungal therapy. Unfortunately, blood cultures from patients with suspected candidemia do not yield positive results in almost half of patients. provides a summary of diagnostic methods for most BSIs. Table 2. Blood Culture Laboratory Diagnosis Organized by Etiological Agent Etiologic Agents Diagnostic Procedures Optimum Specimens Transport Issues Staphylococcus spp Streptococcus spp Enterococcus spp Listeria monocytogenes Enterobacteriaceae Pseudomonas spp (...) inoculated directly into AFB-specific blood culture bottle Inoculated culture vials should be transported to the laboratory ASAP for early incubation. Etiologic Agents Diagnostic Procedures Optimum Specimens Transport Issues Staphylococcus spp Streptococcus spp Enterococcus spp Listeria monocytogenes Enterobacteriaceae Pseudomonas spp Acinetobacter spp HACEK a bacteria Brucella spp Anaerobic bacteria Adults: 2–4 blood culture sets per septic episode 20–30 mL of blood per culture set in adults injected

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2018 Infectious Diseases Society of America

6. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals ? protocol version 5.3

version 4.3 (PPS 2011–2012) can be summarised as follows: ? Inclusion criteria now include chronic care wards in acute care hospitals. ? Inclusion of new structure and process indicators for HAI and AMR prevention at the hospital and ward level. ? Hospital data: Hospital ownership, more details on administrative hospital groups ? Ward data: Simplified ward specialty variable ? Patient data (standard protocol option only): ? Birth weight for neonates ? Surgery codes for patients with surgery since (...) DOCUMENT 4 Inclusion/exclusion criteria Hospitals All acute care hospitals are eligible for inclusion. An acute care hospital is defined in accordance with national definitions. There is no minimal size of hospitals. For administrative hospital groups (hospital ‘mergers’ or ‘trusts’), data should ideally be collected by hospital site. Wards Include all wards in acute care facilities, including, for example, chronic care and long-term care wards, acute psychiatric wards and neonatal ICUs. Excluded

2016 European Centre for Disease Prevention and Control - Technical Guidance

7. Adult Sinusitis

) as initial therapy of acute bacterial rhinosinusitis (ABRS), and 3 new recommendations for managing chronic rhinosinusitis (CRS). Purpose The purpose of this multidisciplinary guideline is to identify quality improvement opportunities in managing adult rhinosinusitis and to create explicit and actionable recommendations to implement these opportunities in clinical practice. Specifically, the goals are to improve diagnostic accuracy for adult rhinosinusitis, promote appropriate use of ancillary tests (...) to confirm diagnosis and guide management, and promote judicious use of systemic and topical therapy, which includes radiography, nasal endoscopy, computed tomography, and testing for allergy and immune function. Emphasis was also placed on identifying multiple chronic conditions that would modify management of rhinosinusitis, including asthma, cystic fibrosis, immunocompromised state, and ciliary dyskinesia. Action statements The update group made strong recommendations that clinicians (1) should

2015 American Academy of Otolaryngology - Head and Neck Surgery

8. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections

250 mg qid po c 40 mg/kg/d in 3–4 divided doses po Some strains of Staphylococcus aureus and Streptococcus pyogenes may be resistant. Clindamycin 300–400 mg qid po 20 mg/kg/d in 3 divided doses po N/A Amoxicillin-clavulanate 875/125 mg bid po 25 mg/kg/d of the amoxicillin component in 2 divided doses po N/A Retapamulin ointment Apply to lesions bid Apply to lesions bid For patients with limited number of lesions Mupirocin ointment Apply to lesions bid Apply to lesions bid For patients with limited (...) . Clindamycin resistance is <1% but may be increasing in Asia N/A Disease Entity Antibiotic Dosage, Adults Dosage, Children a Comment Impetigo b ( Staphylococcus and Streptococcus ) Dicloxacillin 250 mg qid po N/A N/A Cephalexin 250 mg qid po 25–50 mg/kg/d in 3–4 divided doses po N/A Erythromycin 250 mg qid po c 40 mg/kg/d in 3–4 divided doses po Some strains of Staphylococcus aureus and Streptococcus pyogenes may be resistant. Clindamycin 300–400 mg qid po 20 mg/kg/d in 3 divided doses po N/A Amoxicillin

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2014 Infectious Diseases Society of America

9. Bacterial Sepsis following Pregnancy

causing sepsis in the puerperium are: GAS, also known as Streptococcus pyogenes Escherichia coli Staphylococcus aureus Streptococcus pneumoniae meticillin-resistant S. aureus (MRSA), Clostridium septicum and Morganella morganii. GAS is increasingly causing invasive infections worldwide and was directly responsible for 13 of the 29 maternal deaths from infection in the UK during 2006–2008. 1 Since the 2003–2005 survey, 2 MRSA carriage and infection has increased worldwide, with rates of 2.1 (...) to articles published between 1980 and May 2011. Search terms included: ‘postpartum sepsis’, ‘postpartum infection’, ‘septic shock, postpartum’, ‘puerperal sepsis’, ‘puerperal pyrexia’, ‘puerperal fever’, ‘genital tract sepsis’, ‘bacterial sepsis’, ‘toxic shock’, ‘activated protein C and postpartum’, ‘Streptococcus infection and puerperium’, ‘group A streptococcus’, ‘Streptococcus pyogenes’, ‘beta haemolytic Streptococcus and puerperium’. The search was limited to humans and the English language

2012 Royal College of Obstetricians and Gynaecologists

10. Common cold

has a persistent, unilateral nasal discharge in the absence of other symptoms. Influenza — a viral infection that can range from asymptomatic carriage to severe, life-threatening infection. If symptoms of myalgia or fever are prominent, suspect influenza. See the CKS topic on for more information. Streptococcal pharyngitis — a bacterial infection which causes a sore throat. Usually pain is more severe if there is infection with Streptococcus pyogenes is , and cough, sneeze, and nasal congestion (...) Influenza viruses† 5–15 Respiratory syncytial virus 5 Parainfluenza viruses 5 Adenoviruses Less than 5 Enteroviruses Less than 5 Metapneumovirus Unknown Unknown 20–30 * Some episodes of streptococcal pharyngitis may be misclassified as colds. † Influenza sometimes causes milder symptoms which overlap with those normally associated with the common cold. Data from: [ ; ; ; ] Complications What are the complications? The main complications of the common cold are a consequence of viral spread to adjacent

2016 NICE Clinical Knowledge Summaries

13. The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease

rheumatic fever 13 Diagnosis and management of acute rheumatic fever 13 Secondary prevention and rheumatic heart disease control 14 Diagnosis and management of rheumatic heart disease 16 2. Primordial and primary prevention of acute rheumatic fever and rheumatic heart disease 19 Introduction 19 Primordial prevention 20 Primary prevention 21 The role of non- group A streptococcus 28 Recommendations regarding the primordial and primary prevention of acute rheumatic fever and rheumatic heart disease 28 3 (...) , and grades of recommendation 7 Table 2.1 Prevention in the context of ARF and RHD 19 Table 2.2 Recommended antibiotic treatment for streptococcal pharyngitis 24 Table 3.1 Evolution of the diagnostic criteria for ARF since 1992 31 Table 3.2 2012 Updated Australian guidelines for the diagnosis of ARF 32 Table 3.3 Key points in identifying major manifestations of ARF 36 Table 3.4 Upper limits of normal of P-R interval 37 Table 3.5 Key points in identifying minor manifestations of ARF 37 Table 3.6 Suggested

2012 Clinical Practice Guidelines Portal

14. Management of Patients with Infections Caused by Methicillin-Resistant Staphylococcus Aureus

8 h (B-III). 39. Some experts recommend the addition of rifampin 600 mg daily or 300–450 mg PO twice daily to the antibiotic chosen above (B-III) . For patients with concurrent bacteremia, rifampin should be added after clearance of bacteremia. 40. The optimal duration of therapy for MRSA osteomyelitis is unknown. A minimum 8-week course is recommended (A-II). Some experts suggest an additional 1–3 months (and possibly longer for chronic infection or if debridement is not performed) of oral (...) reports [ ] and 1 randomized trial indicate potential efficacy in treating invasive staphylococcal infections, such as bacteremia and endocarditis [ ]. TMP-SMX is effective for the treatment of purulent SSTI in children [ ]. It has not been evaluated for the treatment of invasive CA-MRSA infections in children. Caution is advised when using TMP-SMX to treat elderly patients, particularly those receiving concurrent inhibitors of the renin-angiotensin system and those with chronic renal insufficiency

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2011 Infectious Diseases Society of America

15. Scarlet fever

disease caused by the bacteria Streptococcus pyogenes, also known as group A streptococcus (GAS). The characteristic clinical features include a sore throat, fever, and extensive red, sandpaper-like rash. [ ; ; ] Pathophysiology What is the pathophysiology of it? Scarlet fever is caused by toxin-producing strains of Streptococcus pyogenes , also known as Group A streptococcus (GAS). GAS bacteria can colonise the throat or skin. Asymptomatic pharyngeal carriage of S.pyogenes occurs in 3–23% of healthy (...) Scarlet fever Scarlet fever - NICE CKS Clinical Knowledge Summaries Share Scarlet fever: Summary Scarlet fever is a notifiable infectious disease caused by toxin-producing strains of the group A streptococcus bacterium ( Streptococcus pyogenes ). The bacteria are spread when the person's mouth, throat, or nose comes into contact with infected saliva or mucus (which may be present on cups, utensils, and surfaces), or by aerosol transmission. Outbreaks in schools or other institutions sometimes

2015 NICE Clinical Knowledge Summaries

16. Haemophilus Influenzae Infections (Treatment)

, Ivory Coast, Republic of Senegal and Kenya. J Antimicrob Chemother . 2016 May. 71 Suppl 1:i21-31. . Zafar A, Hasan R, Nizamuddin S, Mahmood N, Mukhtar S, Ali F, et al. Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother . 2016 May. 71 Suppl 1:i103-9. . Satola SW, Collins JT, Napier R, et al. Capsule gene analysis of invasive Haemophilus (...) specialist for assistance with complicated infections. Consult an orthopedic surgeon for surgical drainage of a joint. Previous Next: Prevention The highly effective Hib conjugate vaccine, now routinely administered to infants and children, has dramatically reduced the prevalence of invasive Hib disease. [ ] The vaccine elicits a protective antibody and prevents disease by reducing pharyngeal colonization with Hib. Conversely, there is limited evidence on the effectiveness of the vaccine during pregnancy

2014 eMedicine.com

17. Psoriasis, Guttate (Treatment)

common in individuals younger than 30 years. An upper respiratory tract infection from group A beta-hemolytic streptococci (eg, Streptococcus pyogenes ) often precedes the eruption by 2-3 weeks. [ ] Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis. [ , ] Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have commonly been (...) are often accompanied by slight pruritus. In most cases of guttate psoriasis, a history of an antecedent streptococcal infection, usually of the upper respiratory tract (eg, pharyngitis or tonsillitis), 2-3 weeks prior to the eruption can be elicited. [ , ] Perianal streptococcal infections, which often present as chronic pruritus of the anus in children, have also been associated with guttate psoriasis. [ , ] Multiple other infectious agents have been implicated, although episodes of guttate psoriasis

2014 eMedicine.com

18. Psoriasis, Guttate (Overview)

common in individuals younger than 30 years. An upper respiratory tract infection from group A beta-hemolytic streptococci (eg, Streptococcus pyogenes ) often precedes the eruption by 2-3 weeks. [ ] Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis. [ , ] Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have commonly been (...) are often accompanied by slight pruritus. In most cases of guttate psoriasis, a history of an antecedent streptococcal infection, usually of the upper respiratory tract (eg, pharyngitis or tonsillitis), 2-3 weeks prior to the eruption can be elicited. [ , ] Perianal streptococcal infections, which often present as chronic pruritus of the anus in children, have also been associated with guttate psoriasis. [ , ] Multiple other infectious agents have been implicated, although episodes of guttate psoriasis

2014 eMedicine.com

19. Psoriasis, Guttate (Follow-up)

common in individuals younger than 30 years. An upper respiratory tract infection from group A beta-hemolytic streptococci (eg, Streptococcus pyogenes ) often precedes the eruption by 2-3 weeks. [ ] Streptococcal perianal dermatitis, a superficial bacterial infection of the anus and perianal skin in children, has also been linked with the appearance of guttate psoriasis. [ , ] Although episodes may recur, especially those due to pharyngeal carriage of streptococci, isolated bouts have commonly been (...) are often accompanied by slight pruritus. In most cases of guttate psoriasis, a history of an antecedent streptococcal infection, usually of the upper respiratory tract (eg, pharyngitis or tonsillitis), 2-3 weeks prior to the eruption can be elicited. [ , ] Perianal streptococcal infections, which often present as chronic pruritus of the anus in children, have also been associated with guttate psoriasis. [ , ] Multiple other infectious agents have been implicated, although episodes of guttate psoriasis

2014 eMedicine.com

20. Haemophilus Influenzae Infections (Follow-up)

, Ivory Coast, Republic of Senegal and Kenya. J Antimicrob Chemother . 2016 May. 71 Suppl 1:i21-31. . Zafar A, Hasan R, Nizamuddin S, Mahmood N, Mukhtar S, Ali F, et al. Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother . 2016 May. 71 Suppl 1:i103-9. . Satola SW, Collins JT, Napier R, et al. Capsule gene analysis of invasive Haemophilus (...) specialist for assistance with complicated infections. Consult an orthopedic surgeon for surgical drainage of a joint. Previous Next: Prevention The highly effective Hib conjugate vaccine, now routinely administered to infants and children, has dramatically reduced the prevalence of invasive Hib disease. [ ] The vaccine elicits a protective antibody and prevents disease by reducing pharyngeal colonization with Hib. Conversely, there is limited evidence on the effectiveness of the vaccine during pregnancy

2014 eMedicine.com

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