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Diagnosis and treatment of streptococcal infection
Last reviewed: 07.07.2025
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Diagnosis of streptococcal infection
Clinical diagnosis of streptococcal infection is often difficult. Diagnosis of streptococcal pharyngeal and skin infections in all cases except scarlet fever and erysipelas requires bacteriological studies with species identification of the pathogen. For these purposes, rapid methods of identification of group A streptococci are used, with the help of which it is possible to diagnose acute streptococcal infection within 15-20 minutes without preliminary isolation of a pure culture of the pathogen.
However, the isolation of streptococci does not always indicate their involvement in pathology due to widespread healthy carriage. True infections caused by group A streptococci always initiate the development of a specific immune response, accompanied by a significant increase in the titer of antibodies to one of the extracellular streptococcal antigens - streptolysin O, deoxyribonuclease B, hyaluronidase or nicotinamide adenine dinucleotidase. These diagnostic methods are of practical importance in acute rheumatism and glomerulonephritis.
Along with determining the titer of antistreptococcal antibodies, detection of circulating antigens (free or as part of immune complexes) is important in establishing the role of streptococci in the formation of immunopathological processes. Modern diagnostics of streptococcal infection is ELISA and the use of antisera to discrete antigens of group A streptococci.
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Treatment of streptococcal infection
Treatment of streptococcal infection consists of the use of benzylpenicillin preparations, to which the pathogen remains highly sensitive. Most strains are also highly sensitive to erythromycin, azithromycin, clarithromycin, oxacillin and oleandomycin.
Treatment of streptococcal infection with signs of invasion consists of benzylpenicillin (intravenously or intramuscularly 2.4 million units every 4 hours) and clindamycin (intravenously or intramuscularly 0.6-1.2 g every 6 hours). Treatment of TSS with antibiotics is not always effective (mortality reaches 50%). Normal human immunoglobulin, which contains a wide range of neutralizing antibodies to streptococcal superantigens, is effective.