Streptococcus pharyngitis: A strep throat Disease.

Group A Streptococcus pharyngitis (GAS) , Streptococcus belongs to the family streptococcaceae that live inside our body as normal flora but some of them are pathogenic to us like streptococcus pyogenes cause pyogenic and pharyngitis infection.

Billroth coined the term streptococci means twisted or coiled and Rosenbach coined the species Streptococcus pyogenes which causes pharyngitis.

What is Group A streptococcus pharyngitis:-

Group A Streptococcus pharyngitis (GAS) also known as strep throat is a bacterial infection caused by group A Streptococcus (GAS) or Streptococcus pyogenes.

Group A Streptococcus pyogenes (GAS) is a gram-positive cocci that infects the oropharynx and causes tonsillitis, pharyngitis, and sore throat in severe and long-term infection it may develop into Rheumatic heart disease and acute glomerulonephritis.

How group A Streptococcus pyogenes spread.

Streptococcus pyogenes contain infectious virulent factors that can be categorized as cell wall antigens, toxins, and enzymes.

S.pyogenes spreads through saliva which occurs due to kissing, sharing drinks, sharing utensils, and cups, and also touching the surface or object that has been contaminated with saliva and then touching the mouth, nose, or eyes.

Another way of transmission of infection is coughing, or sneezing without using a tissue or handkerchief and you’re in close scope with an infected person.

Surface antigens of streptococcus pyogenes which are outer cell wall antigens that cause inflammation and outer protein layers such as M, T, and R that lead to vascular leakage and cause Streptococcal shock syndrome.

This M protein is also responsible for the pathogenesis of Rheumatic fever. 

Symptoms of Streptococcus pharyngitis 

Symptoms of streptococcus pyogenes infection start appearing two to five days after exposure to GAS.

Symptoms include are:-

• Sore throat
• Absence of a cough
• Pain when swallowing something 
• Fever called scarlet fever 
• Chill.
• Oral ulcers.
• Swollen lymph nodes in the neck
• Red and swollen tonsils ( Tonsilitis).
• Tiny red spots on the roof of the mouth (called “petechiae”)
• Headache
• Nausea
• Body aches 
• Rashesh 

Prevention from Streptococcus pharyngitis infection:- 

Streptococcus group A infection is an airborne disease caused by respiratory droplets so the best way to prevent GAS infection is to maintain personal hygiene.

Here we try to cover the most important prevention from a strep throat infection.

• Wash your hands or use sanitizer.
• Avoid touching your face, nose, and eyes frequently.
• Cover your mouth with a mask to avoid coming in contact with droplets.
• Avoid close content and infected people.
• Do not share items such as utensils, cups, towels, toothbrushes, and handkerchiefs.
• Clean your house or office floor, and table, and frequently touch items.
• Avoid kissing, hugging, and shaking hands with an infected person.
• Avoid going to public places such as trains, buses, malls, restaurants, and theaters if you are sick and infected with group A Streptococcus.
• Get vaccinated with a flu shot each year to reduce your risk of infection of Group A Streptococcus and other respiratory infections.
• Take a good diet and plenty of water to stay hydrated.
• Take proper sleep and rest.
• Boost your immunity by taking a healthy diet and natural immunity boosters.
• Avoid smoking, tobacco, and drinking alcohol and other substances that irritate your respiratory system.
• See the healthcare provider and your doctor for proper treatment to avoid any serious issues.

Complications:-

Strep throat infection complications are rare but negligence and repeated infection lead to Rheumatic heart disease or Acute Glomerulonephritis.

Streptococcus pyogenes mimic the molecularity of heart cells like heart valve cells, connective tissue like joints, and the skin and brain this causes the immune system to attack self-organs causing rheumatic heart disease.

Other complications of strep throat infection include Acute Glomerulonephritis which is caused by Streptococcus pyogenes exotoxin B (speB).

Symptoms of glomerulonephritis after strep throat infection are:-

• Bloody and smoky urine,
• Malaise,
• Fever, 
• Pitting Edema on eyesight, face, 
• Mild to moderate hypertension.
• Nausea
• Oliguria.

This could happen 1-2 weeks after recovery from strep throat.  

More complications of Streptococcus pyogenes infection are Epiglottitis, Otitis media, Mastoiditis, Sinusitis, and toxic shock syndrome.

Diagnosis of streptococcus pharyngitis:-

Diagnosis of streptococcus (GAS) pharyngitis is done in the laboratory by various techniques to detect the presence of bacteria, antigens, or antibodies.

Specimen collection:-

It depends on the site of lesions and infection.

The common specimen includes a Blood sample, throat swab, and pus swab and the specimens are immediately transported to the laboratory in pikes transport media.

Smear microscopy:-

Smear microscopy of culture shows gram-positive cocci of Group A streptococcus pyogenes Bacteria whereas Direct microscopy is not useful.

Bacitracin sensitivity testing:-

Group A Streptococcus pyogenes is sensitive to bacitracin 0.04 U disk while other Beta hemolytic Streptococcus is resistant.

Lancefield Grouping:-

This test is a confirmatory test for Group A streptococcus pyogenes.

This test involved extraction of C- Carbohydrate antigens followed by testing with group-specific antisera.

Serology:-

A serology test is done to detect antibodies in the patient’s serum in case the patient is susceptible to Rheumatic heart disease or Acute Glomerulonephritis post streptococcus pyogenes infection.

Prognosis:- 

glomerulonephritis in children is good and more than 95% recovered.

While in the case of Rheumatic heart disease, there is no cure, damage to the heart is permanent and only further damage is prevented.

The prognosis of Group A streptococcus pharyngitis is good and self-limiting in 5 to 7 days.

Due to advancements in medicine, various antibiotics are available in pharmacies for better prognosis without any complications so consult your doctor for treatment as soon as possible. 

Who are at risk of streptococcus pharyngitis infection:-

Strep throat is a bacterial disease that can infect anyone but our good immunity fights it and we are not developing any disease some people are at risk of a strep throat infection are:-

• Children under 10 years of age.
• Elderly people
• People who have a Weakened immunity. 
• Malnourished child or adult.
• People are already suffering from tuberculosis, HIV, Hepatitis, or any other disease.
• People who live in close quarters like military barracks.
• Healthcare workers.
• People who have a recent viral infection or cold and cough.
• People who have respiratory tract problems like Asthma, TB, or recently had respiratory tract surgery.
• Smokers.
• Drug abusers who share syringes or glasses.

Can strep throat go away on its own? 

Strep throat is a bacterial disease caused by group A Streptococcus pyogenes and for every foreign body, our body prepares antibodies that will kill that foreign body same is happening in the case of strep throat infection pure body makes antibodies against strep bacteria and thus strep throat go away within three to eight days without any external treatment or antibiotics.

But without taking antibiotics later you may develop complications like rheumatic fever, Glomerulonephritis otitis, etc..so take proper treatment and don’t wait for strep throat to go away on its own.

Difference between a normal sore throat and a strep throat?

Sore throat is caused by common viruses that cause sore throat, cold, cough, watery nose, sneezing, and hoarse voice whereas strep throat is caused by group A Streptococcus pyogenes leads to pharyngitis, swallow tonsillitis, difficulty in swallowing something, high degree fever, ulcer in the oral cavity and swallowed lymph nodes.

What if streptococcus pharyngitis remains untreated?

Untreated Streptococcus pharyngitis will go away on its own after seven to days due to an attack of our immune system that eradicates Streptococcus from our body.

But if your immunity is weak and not able to eradicate Streptococcus pyogenes leads to serious complications like rheumatic fever, Glomerulonephritis, Mastoiditis, Sinusitis, and toxic shock syndrome.

This all could also happen after being completely cut from a strep throat infection so take proper treatment and “don’t die in negligence”.

Vaccine for Streptococcus pyogenes:-

There is no licensed vaccine for Streptococcus pyogenes.

Some Vaccine trials are in process that as the M Protein 30 valent vaccines StreptAnova and conserved M protein vaccine The J8 Vaccine and the StrepIncor vaccine these vaccines are under preclinical trials.

When to Call NHS 111 

When you start seeing symptoms of strep throat infection you should call NHS 111 and tell them your symptoms and your address they will tell you what to do next they will provide a call from the nurse or if it’s an emergency they will refer you to the most suitable healthcare center.

check more Details here NHS 111

Frequently asked questions 

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