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

Streptococcal infections- this is a whole group of diseases caused by streptococci various types. In this case, the respiratory organs and skin are most often affected. A feature of most infections in 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 environment. If you look at them under a microscope, they are most often located one after the other, resembling beads on an invisible thread.
Although unified classification There are no streptococci; based on the antigens that make up the cell wall, streptococci are distinguished from groups A, B, C, D, G…. 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 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 impetus to the development of diseases such as acute rheumatic fever (rheumatism) and, which in themselves are not infectious.
Group C and G streptococci also cause almost all of the diseases listed above, but usually do not lead to 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 affects the skin and subcutaneous fat.

Symptoms of classic erysipelas:

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

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

Scarlet fever

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

temperature rise to 38 C or higher,
headache,
crimson tongue (coated tongue with prominent bright papillae),
sore throat when swallowing (later other symptoms characteristic of sore throat develop: redness of the tonsils and posterior palate, possible appearance of purulent plugs),
a pinpoint, sometimes itchy rash that 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 skin folds,
rapid 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 sore throat is similar to other sore throats caused by various pathogens. Most often in a typical situation the following occurs:

a sore throat,
fever, chills,
general weakness,
redness of varying severity back wall pharynx, 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 damage to the valves and the formation of acquired heart defects.

Impetigo

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

Red papules around the mouth, nose, and also on lower limbs and less often - other parts of the body.
The formation of pustules or vesicles in place of papules, after opening of which characteristic thick golden-yellow crusts form.
General health is usually not affected.
Often found in young children.
A possible complication of the disease is the development of glomerulonephritis.

Other diseases

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

acute onset
slight redness of the skin in the affected area,
when palpating the reddened area - severe and sharp pain,
fever,
weakness, increased fatigue.

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

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

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

Complication – pleural empyema.

Postpartum sepsis and endometritis. Caused by group A and B streptococci. Characterized by a general severe condition and fever.
Toxic shock. In this case, a severe state of multiple organ failure develops. The kidneys and lungs are affected, shortness of breath occurs, arterial pressure falls. If help is not provided in a timely manner, death occurs.
Bacteremia. When streptococcus enters the blood, it can settle in any organ and cause diseases such as purulent arthritis, osteomyelitis, meningitis, endocarditis, peritonitis, retroperitoneal abscesses and abdominal cavity. Bacteremia can occur with necrotizing fasciitis, erysipelas, and even with sore throat (rarely).

Treatment

Diseases caused by streptococcus are treated with antibiotics.

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

Group B streptococci

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

Early streptococcal infection

Typically, the baby is infected during labor or shortly before it begins. 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 life develop meningitis, which is accompanied by the following symptoms:

fever,
whom,
convulsions,
decreased blood pressure,
drowsiness or increased excitability,
sluggish sucking.

Complications of meningitis – hearing loss, delay 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 addition of an infection and the development of purulent inflammation of the foot against the background of diabetes mellitus), pneumonia, infections genitourinary tract, purulent arthritis in frail and elderly people. More rarely observed are endocarditis, peritonitis or abscesses.

Treatment

Treatment of infections caused by group B streptococci begins with benzylpenicillin (ampicillin) in combination with gentamicin.

Other types of streptococci

Viridans streptococci, enterococci (formerly referred to as streptococci), as well as 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 are almost impossible at home, require serious treatment and timely hospitalization. However, even such a “simple” disease as streptococcal tonsillitis can trigger processes of autoimmune damage to the heart valves in the body. For this reason antibacterial treatment must be carried out for a long time (for example, 10 days) even in cases where there is no longer a fever and the throat does not hurt.

Streptococci are bacteria that live in the bodies of animals, on the skin, in the respiratory organs and intestines of humans. Many of these microorganisms do not pose a danger to humans, that is, they belong to saprophytic microflora. However, there are also pathogenic streptococci that cause serious illnesses, ranging from sore throat 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 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 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. The development of the following diseases is associated with them:

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 cause infections of the urinary system, wounds, as well as septic endocarditis.

How does streptococcus infection occur?

The sources of pathogenic streptococci are sick people and healthy carriers. Infection occurs mainly through airborne droplets and household contact (through shared utensils, dirty hands, patient care items, etc.) ways. In this case, the pathogen enters the body through the respiratory tract, less often through lesions on the skin, and also 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 the blood and lymph. In addition, streptococci produce toxins during their life processes, due to which patients develop severe intoxication syndrome and other signs of the disease.

In addition to the routes of infection with streptococcus described above, autoinfection is also possible. For example, when streptococci enter the blood from ulcers on the skin when squeezed out unsuccessfully, from purulent foci in the oral cavity when dental procedures, as well as from the nasopharynx when removing 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 due to infection, but due to allergization of the body. Antibodies to streptococci produced by the system are capable of attacking 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, tissue damage to these internal organs occurs due to a hyperimmune reaction.

Symptoms of the most common streptococcal diseases

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

Streptococcal tonsillitis manifests itself with the following symptoms:

A sharp jump in body temperature to high numbers (39 degrees and above).
Weakness, chills.
Aching in the joints.
Enlargement of 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 damage to the tonsils and internal organs ( purulent processes they do not have symptoms characteristic of streptococcal infection), streptococci cause specific diseases skin:

Streptococcus in children

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

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

The symptoms of this disease are as follows:

The rash, after its disappearance, the skin peels off greatly.
Angina.
"Raspberry" tongue.
Heat.

This is a disease against the background antibacterial therapy almost always ends full recovery for 7-10 days. Subsequently, the entry of pathogenic streptococci into the body leads to the development of sore throat, but repeated cases of scarlet fever are very rare.

Most diseases caused by streptococci are diagnosed by doctors based on specific clinical picture(this applies to scarlet fever, tonsillitis, erysipelas, streptoderma). To confirm the diagnosis, a streptococcus test is performed (smears are taken from the surface of the tonsils, inflamed lesions on the skin, urine, pus, blood, etc. are collected). For more quick diagnostics streptococcal infection in Lately Modern rapid tests are increasingly 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 case of sore throat and scarlet fever, no local antiseptics cannot replace taking antibiotics. Selecting a specific antibacterial agent for the treatment of these diseases is determined by the sensitivity of microorganisms. And since all streptococci are sensitive to penicillins, for streptococcal infections, drugs of this group are primarily used, and as an alternative - cephalosporins and macrolides.

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

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

Streptococci get 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 thread.

Streptococcus belongs to opportunistic microorganisms, 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 more active 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.

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

alpha viridans 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 sexual intercourse, failure to comply with personal hygiene rules).

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

Diagnostics

Should be carried out differential diagnosis streptococcal infection to distinguish

streptococcal sore throat 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 to exclude complications, the following are prescribed:

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

Bacteriological studies are indicated:

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

Treatment of streptococcus

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

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

ampicillin;
oxacillin;
benzylpencillin;
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 course duration is 5-10 days.

If you are allergic to penicillins, antibiotics from the macrolide group (erythromycin, oleandomycin) are prescribed.

For the purpose of detoxification it is indicated drinking plenty of fluids up to three liters per day. Appointed in parallel ascorbic acid to strengthen the walls of blood vessels. Symptomatic drugs to reduce fever (paracetamol, aspirin) are taken for no more than three days.

For streptococcal infections 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 caused by the absorption of endotoxin, which is released when the bacteria die. This provokes allergic reactions and leads to the development of such severe and chronic diseases, such as glomerulonephritis, rheumatism and collagenosis.

The development of streptococcal infection depends on the form and severity of the disease. If internal organs are damaged, 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), a rash appears. First it becomes noticeable on the hands, feet and upper torso, then spreads throughout the body (on the 2-3rd day of illness). The rash disappears in the second week.

About acute tonsillitis they say when they are inflamed tonsils. Streptococcus, having penetrated the tonsils, causes an inflammatory process in them, the nature of which can be different (catarrhal, follicular, lacunar, necrotizing 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 paratonsilitis (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 chills, severe weakness, headache, an inability to swallow, and a feeling of aching in the joints.

In severe cases of tonsillitis, chills continue for several days. Headaches are dull in nature and last 2-3 days. Feeling of aching joints, nagging pain in the lower back lasts 1-2 days. The sore throat is mild at first, then 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 enlargement and the presence of 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, and muscle pain. Against the background of intoxication, consciousness becomes confused, the patient begins to delirium.

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

Inflammation of the bone marrow that extends into all layers of the bone is called osteomyelitis. Developing purulent inflammation, resulting in Bone marrow necrotizes, and an abscess appears at this place, which tends to break out.

People with sharply reduced body defenses may develop sepsis. From the primary focus, streptococcus enters the blood 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, without showing themselves in any way. However, as a result of decreased immunity, streptococcus will begin to actively multiply. 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 people is hemolytic streptococcus. The bacterium thrives in conditions of high humidity and low temperatures. Microorganisms can survive in sputum and dust for several months.

Streptococcus dies under the influence high temperature, sunlight And disinfectants. An infection caused by streptococcus can be easily cured using drugs such as erythromycin and penicillin. It is almost impossible to develop immunity to streptococcus; the bacteria simply infect another internal organ.

There are several ways to become infected with a pathogenic microorganism:

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

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

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

Most dangerous look Streptococcus: pyogenic, which causes most ENT infections.

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

Correct diagnosis of infection

Diagnosing the causative agent of the disease in the case of streptococcal infection is difficult in most cases. 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 take smears from foci of infection:

if you suspect streptococcal sore throat or pharyngitis, remove particles of mucus from the back of the throat and tonsils;
to determine the causative agent of cervicitis or urethritis, take a standard smear from the vagina and collect mucus from the urethra;
to clarify streptoderma or erysipelas, absorb pus with a sterile swab or gently scrape it off upper layer skin with a surgical scalpel dipped in a special oil solution;
to determine the culprit of nephritis, a urine test is necessary;
Sputum examination allows us to determine the cause of bronchitis or pneumonia.

Symptoms of streptococcus

Throat infection

People with unstable or reduced immunity are at risk for infection with streptococcus. These include children, the elderly, pregnant women, and people with autoimmune diseases.

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

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

Streptococcal infection is dangerous due to the rapidly progressing course of the disease. For pharyngitis without treatment moist cough instantly degenerates into tracheitis. If treatment measures are not taken, then on the 4th day complications in the form of otitis media, sinusitis, and lymphadenitis are likely to develop. After a week there is a risk of developing pneumonia.

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

Streptococcal skin infection

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

Classic signs of erysipelas:

the affected area of skin is bright red;
there is a clear distinction between healthy and diseased skin;
the skin is extremely painful and painful to touch;
the site of inflammation swells, the skin is slightly shiny;
An increase in temperature is often observed.

More often, erysipelas affects the legs, less often it appears on the arms and face, sometimes blisters form on the skin, which subsequently burst and become crusty. The appearance of purulent blisters is also associated with impetigo; it is more often diagnosed near the sinuses and near the mouth. Impetigo affects preschoolers who often attend 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 bone matter in one of the parts of the skeleton, as a result the affected area festers and the contents spill out;
rheumatism - streptococci destroy the structure of connective tissue in various organs: joints, small vessels brain, kidneys, pleura, liver, cardiac membranes;
furunculosis - purulent inflammation hair follicles, located in the sweat and sebaceous glands; after a breakthrough, the abscess scars;
sepsis - purulent formations in internal organs (lungs, liver, brain, kidneys), often leading to death due to blood poisoning after an abscess breaks out;
glomerulonephritis - disorder excretory function kidneys due to inflammation of the renal glomeruli.

On the internal organs of a woman’s pelvis, streptococcus forms an inflamed layer of skin that transforms into a tumor.

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

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

Treatment of infection in children

Streptococcal infection is treated only with antibiotics. The bacterium often becomes the culprit of sore throat, pharyngitis, laryngitis, and 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 wide range actions:

Cephalex, Cefazolin, Cephalexin;
Amoxiclav, Flemoklav or Flemoxin, Panclave;
Azithromycin (Summamed, Azimed), Erythromycin).

The speed of recovery is affected by the amount of purulent plaque in the larynx. Usually elevated temperature lasts as long as the tonsils are covered with pustules. To get rid of them, use local remedies for throat irrigation: Ingalipt, Cameton, Angilex, Orasept, Tantum Verde, Hexoral. But it is prohibited to use sprays under 3 years of age due to the risk of laryngeal spasm.

For the treatment of childhood streptoderma, solutions based on fucorcin and 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. The only way to stop the proliferation of streptococcus is antibacterial drugs. Bacteria quickly die under the influence of penicillins: ampicillin, phenoxymethylpenicillin, benzylpenicillin.

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

– a group of diseases including infections caused by streptococcal flora different types and manifested as damage to the respiratory tract and skin. Streptococcal infections include streptococcal impetigo, streptoderma, streptococcal vasculitis, rheumatism, glomerulonephritis, erysipelas, sore throat, scarlet fever and other diseases. Streptococcal infections are dangerous due to their tendency to develop post-infectious complications from various organs and systems. Therefore, diagnosis includes not only identifying 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 types and manifested in the form of damage to the respiratory tract and skin. Streptococcal infections are dangerous due to their tendency to develop post-infectious complications from various organs and systems.

Characteristics of the pathogen

Streptococcus is a genus of facultative anaerobic gram-positive spherical microorganisms that are resistant to environment. Streptococci are resistant to drying and persist in dried biological materials (sputum, pus) for several months. At a temperature of 60 °C. die after 30 minutes, under the influence of chemical disinfectants - after 15 minutes.

The reservoir and source of streptococcal infection is a carrier of streptococcal bacteria or a person suffering from one of the forms of infection. The transmission mechanism is aerosol. The pathogen is released when the patient coughs, sneezes, or during a conversation. Infection occurs by airborne droplets, so the main sources of infection are people with predominant damage to the upper respiratory tract (tonsillitis, scarlet fever). At the same time, it is no longer possible to become infected at a distance of more than three meters. In some cases, it is possible to implement nutritional and contact paths transmission (through dirty hands, contaminated food). For group A streptococci when entering a favorable nutrient medium some food products(milk, eggs, shellfish, ham, etc.) characterized by reproduction and long-term preservation virulent properties.

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

Clinical forms of streptococcal infection

The symptoms of streptococcal infections are extremely diverse due to large quantity probable localization of the source of infection, types of pathogen. Moreover, the intensity clinical manifestations depends on general condition infected body. Group A streptococci are prone to infecting the upper respiratory tract, hearing aid, skin (streptoderma), this group includes the causative agents of scarlet fever and erysipelas.

Diseases that develop as a result of damage by these microorganisms can be divided into primary and secondary forms. Primary forms represent a failure of inflammatory infectious diseases organs that have become the gateway to 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, and streptococcal sepsis are of a toxic-infectious nature.

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

Streptococcal infections of newborns manifest as bacteremia (30% of cases), pneumonia (32-35%) and meningitis. In half of the cases, the infection manifests itself clinically on the first day of life. At the same time, streptococcal infections of newborns are extremely difficult, the mortality rate among patients 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 postpartum women and complications in postoperative period when conducting caesarean section. Streptococcal bacteremia can also occur in individuals with a pronounced weakening of the body’s immune properties (elderly people, patients with diabetes mellitus, immunodeficiency syndrome, malignant neoplasms). Often, streptococcal pneumonia develops against the background of ongoing acute respiratory viral infection. Viridans streptococcus can cause the development of endocarditis and subsequent valvular defects. Mutans group streptococci cause dental caries.

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

Diagnosis of streptococcal infections

Etiological diagnosis of streptococcal infection of the mucous membrane of the pharynx and skin requires bacteriological examination with isolation and identification of the pathogen. An exception is scarlet fever. Since many types of streptococcal bacteria have now acquired a certain resistance to antibiotics of certain groups, careful microbiological examination and performing antibiotic sensitivity testing. Diagnostics carried out 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 test without isolation pure culture. However, identifying the presence of streptococci does not always mean that they are etiological factor pathological process, this fact may also indicate normal 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, x-ray 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 consists of prescribing a course of penicillin antibiotics, to which streptococci are quite susceptible high sensitivity. If the antibiotic is found to be ineffective when used for more than five days, the drug is changed. It is advisable to test the pathogen culture for sensitivity to drugs of different groups (erythromycin, azithromycin, clarithromycin, oxacillin, etc.) 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 (for secondary forms of streptococcal infection), long-acting drugs are often prescribed. Recently noted positive influence on the course of the disease using human immunoglobulin and immunostimulating agents.

Prevention of streptococcal infections

Prevention of streptococcal infection involves measures of personal hygiene and individual prevention during contacts in a narrow team with persons who have respiratory diseases: wearing a mask, cleaning utensils and surfaces that may have been exposed to microorganisms, washing hands with soap. General prevention is to carry out systematic control over the health status of teams: preventive examinations in schools and kindergartens, isolation of identified patients, adequate therapeutic measures, identification hidden forms carriers of streptococcal infections and their treatment. To free the body from the pathogen 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 the hospital of a patient in a weakened state is many times more likely, and the course of the infection in such patients is noticeably more severe. Prevention of infection of mothers and newborns consists of careful compliance with sanitary and hygienic standards and regimes developed for gynecology departments and maternity hospitals.