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Streptococcus pyogenes

Streptococcus pyogenes. Team Case Study 2. The Diagnosis.

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Streptococcus pyogenes

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  1. Streptococcus pyogenes Team Case Study 2

  2. The Diagnosis • Ben Fallerez is a 12 year old boy going to school in France. He complained of a sore throat. The initial diagnosis was Streptococcal pharyngitis. The boy was treated with penicillin, but the symptoms did not resolve. A recurrent infection led the physician to perform a culture and sensitivity. The organism was identified as Streptococcus pyogenes and was reported as being resistant to penicillin.

  3. Streptococcus pyogenes • Group A Streptococcus • Gram positive • Non-motile • Non-spore forming • Occurs in chains • Has a capsule • Adheres to surfaces such as cell walls

  4. People most susceptible • Elderly • Immune suppressed • Chronic cardiac or respiratory disease • Diabetics with skin lesions • African-Americans • Indians • Children of elementary school age

  5. Diseases caused by S. pyogenes • Bacterial pharyngitis, tonsillitis, sinusitis, lymphadenitis, endocarditis, meningitis • Septicemia • Impetigo • Upper respiratory tract infections • Glomerulonephritis • Rheumatic fever • Scarlet fever

  6. Resistance Displayed by Organism • Treatment with penicillin killed all sensitive S. pyogenes, letting S. pyogenes resistant to penicillin grow • Non-compliance • Over-prescribing of antibiotics

  7. Exchange of DNA • DNA exchanged through transformation

  8. Treatment of penicillin resistant S. pyogenes • 500 mg erythromycin qid for 10 days • If resistant to that: • 450 mg clindamycin qid for 10 days

  9. Prognosis • S. pyogenes is benign, self-limiting disease • Symptoms did not subside, was re-evaluated and given different antibiotics because initial pathogen developed resistance to first antibiotic • If he complies, his prognosis is good

  10. Precautions • Take entire prescription • Monitor for signs of an active infection • Re-evaluate with a physical examination and a throat culture and sensitivity to verify pathogen is treated and guarantee no further complications

  11. Works Cited Bingen, E. “Resistance to Macrolides in Streptococcus pyogenes in France in Pediatric Patients”. June 2000. Antimicrobial Agents and Chemotherapy. 10 October 2006. http.//www.punmedcentral.nih.gov/articlerender.fcgi?artid=89896. Gilbert, M.D., David, et al. The Sanford Guide to Antimicrobial Therapy. 36th ed. Sperryville: Antimicrobial Therapy Inc., 2006.

  12. Works Cited • “Group A Streptococcus (GAS) Disease”. Center for Disease Control and Prevention. 11 October 2005. 2 October 2006. http://www.cdc.gov/nicdod/dbind/diseaseinfo/gro upastreptococcal_t.htm. • McGlaughlin, RN, Eileen. “Medical Encyclopedia Info on Strep Throat”. 31 January 2001. 8-11. 7 October 2006. http://www.medicineonline.com/reference/health/ menshealth/conditionsanddiseases.

  13. Works Cited • Nurses Quick Check Diseases. Philadelphia: Lippencott, Williams & Wilkins, 2005 • Patterson, Maria Jevitz. “Streptococcus” Medmicrobook. 2 October 2006. http://gsbs.utmb.edu/microbook/ch013.ht m. • Safani, PhD, M. Physicians’ Drug Manual. 2005. 7 October 2006. http://www.medicallibrary.org/library/secur e/Physicians_Drug_Reso urce.pdf.

  14. Works Cited • Todar, K. “Streptococcus pyogenes”. 2002. Todar’s Online Textbook of Bacteriology. 7 October 2006. http://textbookofbacteriology.net/streptoco ccus.html.

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