Treatment of acute and chronic streptococcal infections. Symptoms and treatment of streptococcus in the blood

streptococcal infections- this is a whole group of diseases, the causative agents of which are streptococci different kind. In this case, the respiratory organs and skin are most often affected. A feature of most infections of this group is that they periodically lead to the development various complications from the internal organs.

What is streptococcus

Streptococci are spherical microorganisms that are quite stable in the outside world. If you look at them under a microscope, then most often they are located one after the other, resembling beads on an invisible thread.
Although unified classification there are no streptococci, according to the antigens that make up the cell wall, streptococci of groups A, B, C, D, G are distinguished .... Oh, and in relation to hemolysis - α, β-hemolytic streptococci, etc.

The most common diseases caused by group A, C, G streptococci

One of the most common diseases caused by streptococcus is acute tonsillitis.

Group A includes β-hemolytic streptococcus, which is the causative agent of scarlet fever, streptococcal tonsillitis and impetigo, and is also capable of giving rise to the development of diseases such as acute rheumatic fever (rheumatism) and which in themselves are not infectious.
Streptococcus groups C, G also cause almost all of the above diseases, but usually do not lead to the appearance of rheumatism.

Symptoms

Erysipelas

In order for this disease to develop, streptococci need to get inside through small lesions on the skin, cracks, abrasions, insect bites, etc. Next, streptococcus infects the skin and subcutaneous fat.

Symptoms of classic erysipelas:

Bright redness of the affected area (most often observed erysipelas legs).
A clear line between healthy and inflamed skin.
To the touch, the affected skin is hotter, shiny, swollen, touching it is painful.
After a few days, blisters may appear on the affected area.
Usually, local changes skin accompanied by fever, weakness, increased fatigue.

At atypical forms erysipelas, there may not be a clear boundary between normal and inflamed areas of the skin, an increase in overall temperature is not always noted, and there is no severe redness.

Scarlet fever

Symptoms of scarlet fever in the classical course of the disease:

temperature rise to 38 C and above,
headache,
crimson tongue (a coated tongue with protruding bright papillae),
sore throat when swallowing (in the future, other symptoms characteristic of angina develop: redness of the tonsils and posterior palate, purulent plugs may appear),
punctate, sometimes itchy rash, which disappears in 6–9 days and is subsequently replaced by peeling (especially of the fingers) in the second week of the disease,
bright rash in the form of lines in the skin folds,
frequent pulse,
lowering blood pressure,
enlargement of the submandibular lymph nodes.

Scarlet fever can serve as an impetus for the development of diseases such as glomerulonephritis, etc.

Angina

Streptococcal tonsillitis is similar to other tonsillitis caused by various pathogens. Most often, in a typical situation, the following is observed:

a sore throat,
fever, chills,
general weakness,
varying degrees of redness rear wall throat, tonsils and soft palate, which may subsequently be accompanied by the appearance purulent plaque,
enlargement of the lymph nodes of the cervical group.

However, such a sore throat can cause a very serious complication - rheumatic fever. acute fever(rheumatism), which can lead to valve damage and the formation of acquired heart defects.

Impetigo

Impetigo is a superficial skin lesion that is also most commonly caused by streptococci. However, impetigo can also appear due to other pathogens, for example, Staphylococcus aureus(Symptoms of staphylococcal impetigo will differ from those of streptococcal infections.)
Streptococcal impetigo is characterized by:

Red papules around the mouth, nose, and also on lower limbs and less often in other parts of the body.
The formation of pustules or vesicles at the site of papules, after opening of which characteristic thick golden-yellow crusts form.
General well-being is usually not disturbed.
It often occurs in young children.
A possible complication of the disease is the development of glomerulonephritis.

Other diseases

Necrotizing fasciitis. Accompanied by inflammation and death of the fascia without the involvement of muscles in the pathological process. This serious condition, which is characterized by:

acute start,
slight redness of the skin in the affected area,
on palpation of the reddened area - severe and sharp pain,
fever,
weakness, fatigue.

In just a few hours, the size of the reddened area of the skin increases, the skin becomes swollen, dark red or burgundy, and the pain is replaced by loss of sensitivity due to the death of the corresponding nerves.

Streptococcal myositis. This disease resembles necrotizing fasciitis, but with a corresponding inflammation of the muscle layer. It can also be accompanied by fever, weakness and complicated by the development of sepsis. Without treatment, it can lead to lethal outcome.
Pneumonia. Typical symptoms:

fever,
dyspnea,
slight cough,
chest pain that gets worse when breathing.

The complication is pleural empyema.

Postpartum sepsis and endometritis. They cause group A and B streptococci. It is characterized by a general severe condition, fever.
Toxic shock. In this case, a severe condition of multiple organ failure develops. Kidneys, lungs are affected, shortness of breath occurs, arterial pressure falls. If timely help is not provided, then death occurs.
bacteremia. When streptococcus enters the bloodstream, it can settle in any organ and cause diseases such as purulent arthritis, osteomyelitis, meningitis, endocarditis, peritonitis, retroperitoneal abscesses and abdominal cavity. Bacteremia can be with necrotizing fasciitis, erysipelas, and even with tonsillitis (rarely).

Treatment

Diseases caused by streptococcus are treated with antibiotics.

In the treatment of diseases caused by streptococcus groups A, C, G, antibiotic therapy is most often used (protected penicillins, amoxicillins, as well as antibiotics of other groups). In case of signs of allergy are prescribed antihistamines, held symptomatic treatment: antipyretic, relieving intoxication, etc. Necrotizing fasciitis and pleural empyema are often treated surgically.

Group B Streptococcus

Streptococci of this group are most often "responsible" for sepsis or meningitis in newborns, as well as postpartum sepsis in parturient women.
In newborns, streptococcal infections are divided into early and late. Early infections develop during the first day of a baby's life, and later - from the age of the first week to the end of 3 months.

Early streptococcal infection

Usually infection of the baby occurs during childbirth or shortly before their onset. Main symptoms: arterial hypotension, drowsiness, respiratory failure, pneumonia, meningitis. In fact, this is sepsis in newborns.

Late streptococcal infection

Most often, children at 4-5 weeks of age develop meningitis, which is accompanied by the following symptoms:

fever
coma,
convulsions
lowering blood pressure,
drowsiness or increased excitability,
sluggish sucking.

Complications of meningitis - hearing loss, delayed neuropsychic development deafness, blindness, epilepsy, mental retardation And so on.

In adults

In addition to postpartum sepsis, group B streptococci can cause soft tissue phlegmon, diabetic foot(more precisely, the attachment of an infection and the development of purulent inflammation of the foot against the background of diabetes mellitus), pneumonia, infections urinary tract, purulent arthritis in debilitated and elderly people. More rarely, endocarditis, peritonitis, or the occurrence of abscesses are observed.

Treatment

Group B streptococcal infections are treated with benzylpenicillin (ampicillin) plus gentamicin.

Other types of streptococci

Viridescent streptococci, enterococci (formerly referred to as streptococci), and other species can cause damage to the gastrointestinal tract, diseases genitourinary system, infective endocarditis, abscesses, sinusitis, meningitis.
Treatment is predominantly antibacterial, taking into account the sensitivity of the pathogen to specific antibiotics.

Conclusion

Many streptococcal infections, the symptoms and treatment of which is almost impossible at home, require a serious attitude and timely hospitalization. However, even such a “simple” disease as streptococcal tonsillitis can trigger the processes of autoimmune damage to the heart valves in the body. For this reason antibiotic treatment it is necessary to carry out for a long time (for example, 10 days) even in cases where there is no longer a temperature and the throat does not hurt.

streptococci- These are bacteria that live in the bodies of animals, on the skin, in the respiratory system and in the intestines of humans. Many of these microorganisms do not pose a danger to humans, that is, they belong to the saprophytic microflora. However, there are also pathogenic streptococci that cause serious illness, ranging from tonsillitis and streptoderma, ending with meningitis and sepsis. In addition, streptococci play an important etiological role in the development of a number of systemic ailments - rheumatism, glomerulonephritis, endocarditis, etc.

Diseases caused by streptococci

All streptococci are divided into four groups (depending on biochemical, biological and other properties):

Alpha hemolytic.
Beta-hemolytic (A, B, C).
Gamma hemolytic.
Non-hemolytic.

Non-hemolytic streptococci they are not dangerous for humans - they do not cause any diseases, which cannot be said about their hemolytic relatives.

So, alpha hemolytic streptococci are the cause of the development infective endocarditis(inflammation of the inner lining of the heart and damage to the heart valves), purulent periodontitis(inflammation connective tissue surrounding the root of the tooth), and when penetrating into the internal organs - abscesses in internal organs. In addition, microorganisms of this group play a leading role in the occurrence of caries.

- the most pathogenic among all streptococci. It is with them that the development of the following diseases is associated:

And finally gamma hemolytic streptococci in most cases, they are saprophytic (normal) microflora of the intestines and upper respiratory tract, which, under certain conditions, can still cause infections of the urinary system, wounds, and septic endocarditis.

How does streptococcus infection occur?

Sources of pathogenic streptococci are sick people and healthy carriers. Infection occurs mainly by airborne droplets and household contact (through common utensils, dirty hands, patient care items, etc.) ways. In this case, the pathogen enters the body through the respiratory tract, less often through damage to the skin, as well as umbilical wound in newborn babies.

After colonization in the primary focus, streptococci begin to actively secrete enzyme substances, thanks to which microbial cells manage to penetrate into the blood and lymph. In addition, streptococci in the process of life produce toxins, due to which patients develop a pronounced intoxication syndrome and other signs of the disease.

In addition to the ways of infection with streptococcus described above, autoinfection is also possible. For example, when streptococci enter the bloodstream from abscesses on the skin when they are unsuccessfully squeezed out, from purulent foci in the oral cavity when dental procedures, as well as from the nasopharynx when removing palatine tonsils or adenoids. In this way, microorganisms spread to the internal organs and cause the development of purulent processes there.

And here systemic diseases, provoked by streptococci, arise not so much because of infection, but because of the allergization of the body. Antibodies to streptococci produced by the system are able to attack their own tissues in the joints, kidneys, and heart. Therefore, when these microorganisms are present in the human body for a long time or re-enter it, as a result of a hyperimmune reaction, damage to the tissues of these internal organs occurs.

Symptoms of the most common streptococcal diseases

IN childhood streptococcal infection most often occurs in the form of scarlet fever, and in adults - tonsillitis. If you do not start taking antibiotics in a timely manner for these diseases and allow long-term persistence of streptococcus in the body, rheumatism, endocarditis, arthritis and glomerulonephritis may develop.

Streptococcal angina manifests itself with the following symptoms:

A sharp jump in body temperature to high numbers (39 degrees and above).
Weakness, chills.
Aches in the joints.
An increase in the palatine tonsils (they seem to swell and become covered first with small pustules, and over time with yellowish purulent deposits).
Enlarged cervical lymph nodes.

In addition to the defeat of the tonsils and internal organs ( purulent processes they do not have symptoms characteristic of a streptococcal infection), streptococci cause specific diseases skin:

Streptococcus in children

For newborns and infants streptococcal infection is great danger. They develop skin diseases (impetigo, ecthyma vulgaris), as well as very severe meningitis and sepsis, due to infection with streptococcus from their mother in utero or during childbirth. In order to prevent infection of newborns, all pregnant women are examined for streptococcus in the last trimester, risk factors are assessed (sowing of pathogenic streptococci from urine during pregnancy, the presence of neonatal streptococcal infection in previously born children, etc.) and, if necessary, prophylactic antibiotic therapy is carried out.

In children after a year, streptococcal infection most often manifests itself in the form of scarlet fever.

The symptoms of this disease are as follows:

Rash, after its disappearance, the skin is very flaky.
Angina.
"Raspberry" language.
Heat.

This disease is in the background antibiotic therapy almost always ends full recovery for 7-10 days. Subsequently, the ingestion of pathogenic streptococci leads to the development of angina, while repeated cases of scarlet fever are very rare.

Most diseases caused by streptococci are diagnosed by doctors on a specific basis. clinical picture(this applies to scarlet fever, tonsillitis, erysipelas, streptoderma). To confirm the diagnosis, an analysis is carried out for streptococcus (smears are taken from the surface of the tonsils, inflamed lesions on the skin, sow urine, pus, blood, etc.). For more rapid diagnosis streptococcal infection in Lately Increasingly, modern rapid analyzes are being used.

Treatment of streptococcal infection

The main and mandatory component of antistreptococcal treatment is . It allows you to eliminate the infection much faster and prevent the development of complications from the heart, kidneys and other organs. In the case of angina and scarlet fever, no local antiseptics cannot replace antibiotics. Choice of specific antibacterial agent for the treatment of these diseases is determined by the sensitivity of microorganisms. And since all streptococci are sensitive to penicillins, in case of streptococcal infection, drugs of this group are primarily used, and as an alternative - cephalosporins, macrolides.

At skin diseases caused by streptococcus, the appropriateness of systemic antibiotic therapy is determined by the doctor individually. However, erysipelas and prolonged streptoderma with a widespread nature of the inflammatory process is always an indication for antibiotics.

Treatment folk remedies with streptococcal infection, it can also be used, but only as an auxiliary. In particular, infusions are considered effective. medicinal herbs(oak bark, chamomile, succession). They are recommended for gargling and treating affected skin. In addition, you can prepare rosehip decoctions, cranberry fruit drinks and take them inside. These drinks contain many

Streptococci got their name from the Greek words for “chain” and “bead”, because under a microscope they look like balls or ovoids and resemble beads strung on a string.

Streptococcus belongs to opportunistic pathogens, is a gram-positive bacterium and is present in the human body. For the time being, the microbe behaves “approximately”, but as soon as the immune system weakens, streptococcus becomes activated and becomes a source of various diseases.

Kinds

About 40 species of streptococci are known. Depending on the presence of certain polysaccharides in their composition, these microbes were divided into groups from A to V.

Pathogenic streptococci, the most dangerous to humans, are those that are in group A. In turn, group A streptococci are divided into 3 subgroups based on their ability to destroy red blood cells:

alpha-green streptococci;
beta-hemolytic streptococci;
gamma streptococci.

Group A streptococci of the beta-hemolytic subgroup are called pyogenic streptococci (Streptococcus pyogenes). They are responsible for the development of many diseases:

scarlet fever, tonsillitis;
pharyngitis, bronchitis, pneumonia.
abscess, sepsis;
osteomyelitis;
lesions of the genitourinary system.

Causes

The source of infection is a sick person or a carrier of streptococcus (much less often). Infection occurs in several ways:

contact-household (penetration of a microbe through damaged skin during close contact with a sick person or through infected household items: dishes, toys, bedding, etc.);
airborne (with particles of mucus and saliva when coughing, sneezing, screaming);
vertical (infection of the fetus during pregnancy and childbirth);
sexual (unprotected intercourse, non-compliance with the rules of personal hygiene).

In addition, the risk of streptococcal infection increases sharply with weakening defensive forces body (hypothermia, chronic diseases, HIV infection, etc.).

Diagnostics

Should be carried out differential diagnosis streptococcal infection to distinguish

streptococcal tonsillitis from diphtheria and infectious mononucleosis,
scarlet fever from rubella and measles,
erysipelas from dermatitis and eczema.

The diagnosis of diseases caused by streptococcus is established on the basis of a characteristic clinical picture.

Also, to clarify the nature and severity of the infection and in order to exclude complications, the following are prescribed:

general blood and urine tests;
electrocardiography;
radiography of the lungs;
Ultrasound of internal organs;
other additional methods of examination.

Bacteriological studies are shown:

sputum cultures;
taking smears from the tonsils, affected areas of the skin.

Streptococcus treatment

The treatment of streptococci is carried out by the doctor whose profile corresponds to the form of the disease. For example, a dermatologist treats erysipelas, a surgeon treats abscesses, phlegmon and osteomyelitis, a urologist supervises cystitis, and so on.

Etiotropic therapy (elimination of the cause of the disease) consists in prescribing antibiotics penicillin series:

ampicillin;
oxacillin;
benzylpecillin;
amoxicillin;
bicillin-5;
and others.

These are the only antibiotics to which streptococci are not able to acquire resistance.

Depending on the severity and form of the disease, antibiotics are prescribed orally or intramuscularly 4 times a day, the duration of the course is 5-10 days.

In the case of an allergy to penicillins, antibiotics from the macrolide group (erythromycin, oleandomycin) are prescribed.

For the purpose of detoxification plentiful drink up to three liters per day. In parallel appointed ascorbic acid to strengthen the walls of blood vessels. Symptomatic drugs to reduce the temperature (paracetamol, aspirin) are taken no more than three days.

With streptococcal infection in the oropharynx, rinsing the mouth and throat with a solution of furacillin is prescribed (for hygienic, but not for therapeutic purposes).

Consequences and prognosis

The consequences of streptococcal infection are due to the absorption of endotoxin, which is released when the bacteria die. It provokes allergic reactions and leads to the development of such severe and chronic diseases like glomerulonephritis, rheumatism and collagenosis.

The development of streptococcal infection depends on the form and severity of the disease. With damage to internal organs, the prognosis for life is relatively favorable.

Symptoms of streptococcal infections

Common forms:

The disease begins abruptly, with a rise in temperature to high numbers and severe intoxication (weakness, lack of appetite, nausea, headache, sore throat when swallowing). After a few hours (about 6-12 hours) a rash appears. First, it becomes noticeable on the hands, feet and upper body, then spreads throughout the body (2-3 days of illness). The rash disappears in the second week.

About acute tonsillitis say when inflamed palatine tonsils. Streptococcus, having penetrated into the tonsils, causes an inflammatory process in them, the nature of which can be different (catarrhal, follicular, lacunar, necrotic tonsillitis).

If the barrier function of the tissues that surround the tonsils is reduced, then they are also involved in the inflammatory process, resulting in paratonsillitis (peritonsillar abscess - acute inflammation V soft tissues tonsils).

The incubation period ranges from several hours to 2-5 days. The disease begins acutely and suddenly. There is a chill, severe weakness, headache, it is impossible to swallow, there is a feeling of aching in the joints.

In severe angina, chills continue for several days. Headaches are dull in nature and last 2-3 days. Feeling of ache in the joints, pulling pains in the lower back remains 1-2 days. The pain in the throat is at first mild, then it intensifies and reaches a peak on the second day.

Angina differs from scarlet fever in the absence of a rash.

When examining the tonsils, their significant increase and the presence of a yellow-white purulent plaque or whitish vesicles (follicles) are noted.

Erysipelas is acute and usually severe. There is a significant increase in temperature (39-40°C), severe headache, severe weakness, chills, muscle pain. Against the background of intoxication, consciousness becomes confused, the patient begins to rave.

A characteristic sign of erysipelas is a local inflammation of the skin. The place of inflammation rises above the level healthy skin, characterized by a bright red color, elevated temperature and clear boundaries. When severe course blisters and hemorrhages appear on the affected area.

Inflammation of the bone marrow that penetrates all layers of the bone is called osteomyelitis. Developing purulent inflammation, resulting in Bone marrow necrotic, and in this place an abscess occurs, which tends to break out.

People with sharply reduced body defenses may develop sepsis. From the primary focus, streptococcus enters the bloodstream and spreads throughout the body (septicemia). At the same time, in different places new foci of infection are formed - abscesses in the lungs, liver, kidneys, brain, etc. (septicopyemia).

Microflora human body inhabits great amount bacteria, microorganisms, viruses. One of them is called streptococcus. About 60% of streptococcus colonies live in the throat, not manifesting themselves in any way. However, as a result of a decrease in immunity, streptococcus will begin to multiply actively. It causes dangerous inflammatory processes in the nasopharynx, on the skin, in the organs of the urinary system. Timely initiation of treatment saves a person from serious complications The main thing is to correctly identify the causative agent of the disease.

Causes of Streptococcus Infection

To date, doctors have studied 27 types of streptococcus. The greatest danger to humans is hemolytic streptococcus. The bacterium thrives in high humidity conditions. low temperatures. In sputum, dust, microorganisms can exist for several months.

Streptococcus dies under the influence high temperature, sunlight And disinfectants. The infection caused by streptococcus is easy to cure side by side (erythromycin and penicillin). It is almost impossible to develop immunity to streptococcus, the bacteria simply infect another internal organ.

There are several ways of infection with a pathogenic microorganism:

airborne - the main cause of infection; drops with streptococcus are sprayed during a conversation, coughing, sneezing;
food - most often streptococcus settles on expired dairy, meat, Great chance meet him in salads with mayonnaise, products with protein cream, sandwiches;
sexual - streptococcus easily penetrates through unprotected sexual contact; more prone to infection is a partner who has inflammation of the genitourinary system;
household - outbreaks of streptococcal infection are not uncommon in children's groups, where the bacterium is transmitted through toys, towels, dishes;
from mother to newborn.

Because streptococcus is part of normal microflora, a person can infect himself. Children often become infected after an exacerbation of tonsillitis, rhinitis, sinusitis. It is very difficult to get rid of streptococcus, which lives in medical institutions.

Bacteria living in hospitals are more resistant to antibiotics, making them harder to treat.

Most dangerous view streptococcus: pyogenic, which provokes most infections of ENT diseases.

Learn about streptococcal skin infections from the Live Healthy video program.

Proper diagnosis of infection

In most cases, it is difficult to diagnose the causative agent of the disease in the case of streptococcal infection. Sometimes the disease has clear symptoms (scarlet fever or erysipelas) and does not require additional bacteriological research.

For maximum quick cure it is necessary to pass smears from the foci of infection:

if streptococcal tonsillitis or pharyngitis is suspected, particles of mucus are removed from the back of the throat and tonsils;
to determine the causative agent of cervicitis or urethritis, a standard swab is taken from the vagina, mucus is collected from the urethra;
to clarify streptoderma or erysipelas, absorb pus with a sterile swab or gently scrape off upper layer skin with a surgical scalpel dipped in a special oil solution;
to determine the culprit of nephritis, a urine test is needed;
sputum examination allows you to determine the cause of bronchitis or pneumonia.

Streptococcus symptoms

throat infection

At risk of persons susceptible to infection with streptococcus are people with unstable or reduced immunity. These include children, the elderly, pregnant women, individuals with autoimmune diseases.

Intensive growth of colonies of pathogens in the throat is accompanied by the following symptoms:

temperature indicators reach 39-40;
arises strong pain in the throat, which is aggravated by swallowing;
cervical increase;
the disease begins abruptly with concomitant strong weakness in body;
tonsils swell strongly, protrude from their physiological boundaries;
purulent appears on the tonsils white coating either in the form of a cobweb (tonsillitis), or pointwise (tonsillitis);
the patient has temperature fluctuations from fever to chills;
there is pain when opening the mouth;
the occipital muscles become inactive.

Streptococcal infection is dangerous with a rapidly progressive course of the disease. With pharyngitis in the absence of treatment moist cough instantly degenerates into tracheitis. If treatment measures are not taken, then on the 4th day, the development of complications in the form of otitis media, sinusitis, and lymphadenitis is likely. A week later, there is a risk of developing pneumonia.

TO additional features infections include loss of appetite, nausea, headache.

Strep infection on the skin

The second favorite place of streptococcus is the skin. The infection can penetrate deep through the bite of an insect, from infected person through an abrasion, a scratch. Most known diseases skin caused by streptococcus: erysipelas, impetigo.

Classic signs of erysipelas:

the affected area of the skin has a bright red color;
there is a clear distinction between healthy and diseased skin;
the skin is extremely painful, it hurts to touch it;
the place of inflammation swells, the skin slightly shines;
fever is often observed.

More often, erysipelas affects the legs, less often appears on the hands and face, sometimes bubbles form on the skin, which subsequently burst and become covered with a crust. The appearance of purulent vesicles is also associated with impetigo, it is more often diagnosed near the sinuses and near the mouth. Impetigo affects preschoolers, often in children's groups.

Other diseases

In addition to the mucous membrane of the throat and skin, streptococcus can multiply on other organs.

Streptococcal infection leads to various diseases

An active increase in bacterial colonies leads to other types of streptococcal infections:

osteomyelitis - the death of the bone substance in one of the sections of the skeleton, as a result, the affected area fester and the contents spill out;
rheumatism - streptococci destroy the structure of the connective tissue in various bodies: joints, small vessels brain, kidneys, pleura, liver, heart membranes;
furunculosis - purulent inflammation hair follicles located in sweat and sebaceous glands; after a breakthrough, the abscess is scarred;
sepsis - purulent formation in the internal organs (lungs, liver, brain, kidneys), often fatal due to blood poisoning after the breakthrough of the abscess;
glomerulonephritis is a disorder excretory function kidneys due to inflammation of the renal glomeruli.

On the internal organs of the small pelvis of a woman, streptococcus forms an inflamed layer of skin, which transforms into a tumor.

Signs of infection are similar to gonorrhea: painful urination, yellow discharge with blood, severe pain at the bottom of the spine.

Early diagnosis of the disease will quickly get rid of streptococcus and its complications.

Treatment of infection in children

Streptococcal infections are treated with antibiotics only. The bacterium often becomes the culprit of tonsillitis, pharyngitis, laryngitis, scarlet fever in children. The duration of treatment depends on the severity and stage of the disease.

The course of antibiotics is usually 5 to 10 days.

Are used a wide range actions:

Cefalex, Cefazolin, Cefalexin;
Amoxiclav, Flemoklav or Flemoxin, Panklav;
Azithromycin (Summamed, Azimed), Erythromycin).

The rate of recovery is affected by the amount of purulent plaque in the larynx. Usually fever lasts until the tonsils are covered with pustules. To get rid of them, use local funds for irrigation of the throat: Ingalipt, Cameton, Angilex, Oracept, Tantum Verde, Geksoral. But up to 3 years, it is forbidden to use sprays because of the risk of spasm of the larynx.

For the treatment of childhood streptoderma, solutions based on fucorcin, resorcinol are used. They wipe the affected areas several times a day. Antihistamines are recommended to relieve itching. Sometimes immunostimulating agents are prescribed to stimulate the body's own defenses.

If competent therapy is started on time according to the doctor's recommendations, the child will recover by the end of the 5th day of the course of antibiotics.

How to cure streptococcus on the skin in adults?

But adults often have to think about how to treat a streptococcal infection on the skin. Stop the reproduction of streptococcus can only antibacterial drugs. Bacteria quickly die under the influence of penicillins: ampicillin, phenoxymethylpenicillin, benzylpenicillin.

Comprehensive use of antibiotics and topical agents speed up the healing process.

- a group of diseases, including infections caused by streptococcal flora different types and manifested in the form of damage to the respiratory tract and skin. Streptococcal infections include streptococcal impetigo, streptoderma, streptococcal vasculitis, rheumatism, glomerulonephritis, erysipelas, tonsillitis, scarlet fever and other diseases. Streptococcal infections are dangerous with a tendency to develop post-infectious complications from various organs and systems. Therefore, diagnosis includes not only the identification of the pathogen, but also instrumental examination cardiovascular, respiratory and urinary systems.

General information

- a group of diseases, including infections caused by streptococcal flora of various species and manifested as damage to the respiratory tract and skin. Streptococcal infections are dangerous with a tendency to develop post-infectious complications from various organs and systems.

Exciter characteristic

Streptococcus is a genus of facultative anaerobic Gram-positive spherical microorganisms resistant to environment. Streptococci are resistant to desiccation; they remain in dried biological materials (sputum, pus) for several months. At a temperature of 60 °C. die after 30 minutes, under the action of chemical disinfectants - after 15 minutes.

The reservoir and source of streptococcal infection is a carrier of streptococcal bacteria or a person who is sick with one of the forms of infection. The transmission mechanism is aerosol. The causative agent is released by patients when coughing, sneezing, during a conversation. Infection occurs by airborne droplets, so the main sources of infection are people with a primary lesion of the upper respiratory tract (tonsillitis, scarlet fever). At the same time, it is no longer possible to get infected at a distance of more than three meters. In some cases, it is possible to implement alimentary and contact ways transmission (through dirty hands, contaminated food). For group A streptococci, when they enter a favorable nutrient medium some food products(milk, eggs, shellfish, ham, etc.) reproduction and long-term preservation virulent properties.

Probability of occurrence purulent complications when infected with streptococci, it is high in people with burns, wounds, pregnant women, newborns, patients after operations. Group B streptococci commonly cause urinary tract infections and can be transmitted through sexual contact. Newborns often get the infection as a result of infection amniotic fluid and when passing birth canal. The natural susceptibility of a person to streptococcal bacteria is high, the immunity is type-specific and does not prevent infection with streptococci of another species.

Clinical forms of streptococcal infection

The symptoms of streptococcal infections are extremely diverse due to a large number probable localizations of the focus of infection, types of pathogen. In addition, the intensity clinical manifestations depends on general condition infected organism. Group A streptococci are prone to damage to the upper respiratory tract, hearing aid, skin (streptoderma), this group includes pathogens of scarlet fever and erysipelas.

Diseases that have developed as a result of damage by these microorganisms can be divided into primary and secondary forms. Primary forms represent an inflammatory failure infectious diseases organs that have become the gateway of infection (pharyngitis, laryngitis, tonsillitis, otitis media, impetigo, etc.). Secondary forms develop as a result of the inclusion of autoimmune and toxic-septic mechanisms for the development of inflammation in various organs and systems. Secondary forms of streptococcal infections with an autoimmune mechanism of development include rheumatism, glomerulonephritis, and streptococcal vasculitis. Necrotic lesions of soft tissues, meta- and peritonsillar abscesses, streptococcal sepsis are of a toxin-infectious nature.

Rare clinical forms of streptococcal infections: necrotic inflammation of muscles and fascia, enteritis, toxic shock syndrome, focal infectious lesions organs and tissues (for example, soft tissue abscess). Group B streptococci cause the vast majority of infections in newborns, although they occur at any age. This is due to the predominant lesion of the genitourinary tract by this pathogen and infection of newborns intranatally.

Streptococcal infections in newborns manifest as bacteremia (30% of cases), pneumonia (32-35%), and meningitis. In half of the cases, the infection manifests itself clinically in the first day of life. At the same time, streptococcal infections in newborns are extremely difficult, the mortality rate among the sick is about 37%. Meningitis and bacteremia may appear later. In this case, about 10-20% of the sick die, and half of the survivors have developmental disorders.

Group B streptococcal infections are often the cause of postpartum endometritis, cystitis, adnexitis in puerperas and complications in postoperative period during the caesarean section. Streptococcal bacteremia can also be observed in persons with a pronounced weakening of the body's immune properties (the elderly, patients with diabetes mellitus, immunodeficiency syndrome, malignant neoplasms). Often, against the background of an ongoing ARVI, streptococcal pneumonia develops. Streptococcus viridans can cause endocarditis and subsequent valvular defects. Streptococci of the mutans group cause tooth decay.

Complications of streptococcal infections are autoimmune and toxicoseptic secondary lesions of organs and systems (rheumatism, glomerulonephritis, necrotic myositis and fasciitis, sepsis, etc.).

Diagnosis of streptococcal infections

The etiological diagnosis of streptococcal infection of the mucous membrane of the pharynx and skin requires a bacteriological study with the isolation and identification of the pathogen. An exception is scarlet fever. Since many species of streptococcal bacteria have now acquired some resistance to certain groups of antibiotics, careful microbiological research and performing an antibiotic susceptibility test. Diagnosis, made in sufficient volume, contributes to the choice effective tactics treatment.

Express diagnosis of group A streptococci allows you to identify the pathogen within 15-20 minutes from the moment of taking the analysis without isolation pure culture. However, detection of the presence of streptococci does not always mean that they are etiological factor pathological process, this fact can also speak about the usual carriage. Rheumatism and glomerulonephritis are almost always characterized by an increase in the titer of antibodies to streptococci already from the first days of exacerbation. The titer of antibodies to extracellular antigens is determined using a neutralization reaction. If necessary, an examination of organs affected by streptococcal infection is carried out: examination by an otolaryngologist, radiography of the lungs, ultrasound of the bladder, ECG, etc.

Treatment of streptococcal infections

Depending on the form of streptococcal infection, treatment is carried out by a gynecologist, urologist, dermatologist, pulmonologist or other specialists. Etiological treatment primary clinical forms of streptococcal infections is to prescribe a course of antibiotics of the penicillin series, to which streptococci have quite high sensitivity. If the ineffectiveness of the antibiotic is revealed when it is used for more than five days, the drug is changed. It is advisable to test the culture of the pathogen for sensitivity to drugs of different (erythromycin, azithromycin, clarithromycin, oxacillin, etc.) groups in order to more reliably select an antibiotic. Practice shows that tetracycline drugs, gentamicin and kanamycin are ineffective.

Pathogenetic and symptomatic treatment depends on clinical form diseases. If it is necessary to prescribe long courses of antibiotic therapy (with secondary forms of streptococcal infection), long-acting drugs are often prescribed. Recently noted positive influence on the course of the disease, the use of human immunoglobulin and immunostimulating agents.

Prevention of streptococcal infections

Prevention of streptococcal infection involves personal hygiene and individual prevention when contacts in a narrow team with persons who have respiratory diseases: wearing a mask, cleaning dishes and surfaces that could get microorganisms, washing hands with soap. General prevention consists in the implementation of systematic control over the health status of teams: preventive examinations in schools and kindergartens, isolation of identified patients, adequate medical measures, detection hidden forms carriage of streptococcal infections and their treatment. To rid the body of pathogens and complete cure WHO recommends the use of penicillins for at least 10 days.

Particular attention should be paid to the prevention of nosocomial infection with streptococcal infection, since infection in a hospital in a patient who is in a weakened state is many times more likely, and the course of infection in such patients is much more severe. Prevention of infection in parturient women and newborns consists in careful observance of sanitary and hygienic standards and regimen developed for gynecology departments and maternity hospitals.