Streptococcal Infections

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1 Streptococcal Infections Introduction Streptococcal, or strep, infections cause a variety of health problems. These infections can cause a mild skin infection or sore throat. But they can also cause severe, life threatening conditions. Strep infections are caused by specific types of bacteria. There are many types. The types that effect humans are known as group A and group B. Each of these types can cause different infections. This reference summary will explain streptococcal infections. It will cover group A and group B strep infections. It will also talk about the diagnosis and treatment options. Streptococcal Infections Streptococcus is a type of bacteria. When the bacteria cause an infection, the illness is commonly called a strep infection. Strep infections are divided into two groups: group A and group B. This program will provide an overview of each type. Streptococcus bacteria can spread in many ways. It is often spread through direct contact with mucus from the nose or throat of infected people. It can also spread through contact with infected wounds or sores on the skin. Some types of strep may be passed from mother to baby during childbirth. Strep infections cause a number of health problems. Some examples include: Blood infections. Skin infections. Sore throat. Toxic shock syndrome. Some group A strep infections, such as strep throat or scarlet fever, are common in children and adults. Others are less common and can be life threatening. 1

2 Group B strep infections are most common in newborns. But adults can also get group B strep infections. These infections are more common in the elderly or in people who already have health problems. The next two sections discuss the symptoms and health problems that can be caused by each type of strep infection. Group A Strep Group A Streptococcus is a bacterium that is commonly found in the throat and on the skin. People may carry this type of bacteria with no symptoms of illness. Most infections caused by group A strep are mild, such as strep throat. Strep throat is the most common throat infection caused by bacteria. It causes a sore, red throat. It can also cause white spots on the tonsils. Scarlet fever is another mild illness caused by group A strep and often follows strep throat. Scarlet fever causes a bright red rash on the body. Group A strep may also cause a skin infection called impetigo. Impetigo often starts when bacteria get into a break in the skin, such as a cut or scratch. Symptoms of impetigo start with red or pimple-like sores surrounded by red skin. The sores fill with pus, then break open after a few days and form a thick crust. Impetigo is most common in children and infants. Group A strep can also cause another skin infection called cellulitis. Cellulitis infects the deepest layer of skin. It causes the skin to become red, hot, irritated, and painful. It is most common on the face and lower legs. Cellulitis can be serious, possibly even deadly. Prompt treatment is important. Serious, sometimes life threatening infections may be caused by group A strep. These infections are not as common. Group A strep may cause necrotizing fasciitis or toxic shock syndrome. Necrotizing fasciitis is a severe skin infection. It causes death of infected tissue. The death of this tissue is called necrosis. Necrotizing fasciitis is sometimes called "flesh-eating disease." It spreads quickly, causing the death of skin, muscle, and other tissues in the body. Necrotizing fasciitis causes the skin to become red and warm to the touch. The skin may also be swollen. A person with this type of skin infection usually has a high fever and feels very sick. 2

3 Toxic shock syndrome is a life threatening condition caused by toxins that some strains of strep bacteria make. It causes a sudden drop in blood pressure. It also causes the organs in the body to stop working. Toxic shock syndrome often causes the following symptoms: A weak and rapid pulse. Difficulty breathing. Dizziness or confusion. Headache. High fever. Muscle aches. Pale skin. Acute rheumatic fever is a potential complication of an infection caused by Group A strep. It can affect the heart, joints, skin and brain. Symptoms of acute rheumatic fever include: Abdominal pain. Arthritis, joint pain and joint swelling. Fever. Muscle weakness. Nosebleeds. Skin rash. Shortness of breath and chest pain. Post-streptococcal glomerulonephritis, or PSGN, could also be caused by a Group A strep infection. PSGN causes inflammation of the kidney. Symptoms include pale skin, lack of energy, loss of appetite, headache and back pain. If you have any of the symptoms of a group A strep infection, talk to your health care provider. If you have symptoms of a more serious illness, seek emergency medical attention. 3

4 Group B Strep Group B Streptococcus is a bacterium that is commonly found in the intestines and the rectum. In women, it may sometimes be found in the vagina. People may carry this type of bacteria with no symptoms of illness. The vagina is a part of the female reproductive system. It connects the uterus, or womb, to the outside of the body. It is also called the birth canal. Group B strep can cause illness in people of all ages. But group B strep infections are much more common in newborns. In newborns, group B strep can cause: Sepsis, an infection of the blood. Pneumonia, an infection of the lungs. Meningitis, an infection of the fluid and lining around the brain. Some newborns infected with group B strep show symptoms in the first week of life. Other babies may not show symptoms until the second week of life and up to 3 months of age. Symptoms of group B strep in newborns include: Bluish skin. Difficulty breathing. Difficulty feeding. Fever. Irritability. Limpness or difficulty waking the baby. Pregnant women may carry the bacteria, which usually does not cause any symptoms. It can then be passed to the baby during birth. Routine testing for group B strep is often done late in pregnancy to see if a newborn will be at risk. Adults can also be infected with group B strep, especially if they are elderly or already have health problems, such as heart disease or diabetes. The risk of group B strep infection in adults increases with age. 4

5 In adults, strep B can cause: Blood infections. Pneumonia, a lung infection. Skin infections. Urinary tract infections. It is unknown what causes group B strep infections in adults. Group B strep is commonly found in the intestines or rectum. This may be a source of some infections. Diagnosis If you have the symptoms of a strep infection, your health care provider will try to find out if strep bacteria are the cause. Your health care provider will first ask about your symptoms and medical history. A physical exam will also be performed. If your health care provider thinks you may have a strep infection, tissue or fluid samples may be taken. These samples are used in the lab to grow bacteria that can then be identified. Treatment Antibiotics are used to treat both group A and group B strep infections. Antibiotics are special medicines used to fight bacterial infections. Antibiotics must be taken exactly as prescribed by your health care provider. You must take the full amount for as many days as your health care provider tells you. Stopping antibiotics too soon may make the infection worse. In pregnant women who have tested positive for group B strep, antibiotics are given through an IV during labor. This helps to prevent an infection in the baby. More severe illnesses caused by strep bacteria may require additional treatments. For example, necrotizing fasciitis often requires surgery to remove dead tissue. Prevention You can lower your risk for strep infections in several easy ways: Wash your hands frequently. Cover wounds. Watch for signs of infection. 5

6 Careful hand washing is the best way to defend against germs, including strep bacteria. Wash your hands for at least 20 to 30 seconds. Next, dry them with a disposable towel. Use a second towel to turn off the faucet. You can also use an alcohol based hand sanitizer. You should also keep cuts and other damaged skin clean and covered. Use sterile, dry bandages until the wounded skin heals. Pus from infected sores may contain strep bacteria. Keeping wounds covered will help keep the bacteria from spreading. Also make sure to watch for signs of infection if you have a cut or wound. Signs of infection are redness, swelling, drainage, and pain at the wound site. Seek immediate medical care if you have these symptoms, especially with a fever. Pregnant women can also prevent spreading the infection to their babies by getting tested for group B strep late in pregnancy. The test is often done 35 to 37 weeks into the pregnancy. Antibiotics are given during labor if the test is positive. This can prevent the spread of the bacteria to the baby. Summary Streptococcal, or strep, infections cause a variety of health problems. These infections can cause a mild skin infection or sore throat. But they can also cause severe, life threatening conditions. Strep infections are caused by a specific type of bacteria called Streptococcus. There are two types: group A and group B. Each of these groups can cause different types of infections. Strep infections are most often diagnosed through a physical exam and tests to look for signs of the bacteria. Infections are treated using antibiotic medicine. Severe infections may also require other treatments, such as surgery. You can lower your risk for strep infections in several easy ways: Wash your hands frequently. Cover wounds. Watch for signs of infection. If you are pregnant, you can also prevent an infection in your baby by getting tested for group B strep bacteria. Antibiotics during labor can prevent the spread of the bacteria to your baby if you are infected. 6

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