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Severe Invasive Disease • Toxic Shock syndrome – occurrence of shock, multiorgan multiorgan system failure early in the course of infection
– (+)soft tissue infection(cellulitis,absc ess,necrotizing fasciitis)w/ increasing pain
Hypotension plus two or more Renal Impairment Coagulopathy Hepatic involvement ARDS Scarlet fever rash Soft tissue necrosis
Definite case Clinical criteria plus group A streptococcus from a normally sterile site
Probable case Clinical criteria plus group A streptococcus from a non strerile site
Severe Invasive Disease • Focal and systemic infections that do not meet the criteria for TSS and necrotizing fasciitis – Meningitis – BPN – Peritonitis – Puerperal sepsis – Osteomyelitis Suppurative arthritis arthritis – Suppurative – Myositis – Surgical wound infection
Suppurative Suppurativ e Complications Secondary to local inflammation: peritonsillar peritonsillar abscess abscess retropharyngeal abscess Direct extension: otitis otitis media media sinusitis Lymphatic spread: lymphadenitis Bacteremia: Bacteremia: sepsis osteomyelitis pneumonia
Non-suppurative complication complicationss Rheumatic Fever: -associated w/ serotypes M1,2,5,6,18,24 M1,2,5,6,18,24 -follows a streptococcal pharyngitis -abnormal host immnue response to an undefined component of GABS->immunologic damage -latent period: 1-3 wks support immunologic tissue damage Glomerulonephritis: -acute nephritic syndrome 1-2 wks after a streptococcal pharyngitis pharyngitis or skin infection -probably immune complex –mediated (depressed C3)
Bacte-Pedia
