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Diagnosis and treatment of streptococcal infection
Last reviewed: 23.04.2024
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Diagnosis of streptococcal infection
Clinical diagnosis of streptococcal infection is often difficult. The diagnosis of streptococcal pharyngeal and skin infections in all cases, except scarlet fever and erysipelas, requires the conduct of bacteriological studies with species identification of the pathogen. For these purposes, rapid methods for the identification of Group A streptococci are used, with the help of which it is possible to diagnose acute streptococcal infection within 15-20 min without first isolating the pure culture of the pathogen.
However, the allocation of streptococci does not always indicate their involvement in pathology in connection with a widespread healthy carrier. The true infections caused by Group A streptococci always initiate the development of a specific immune response accompanied by a significant increase in the antibody titer 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 the definition of anti-streptococcal antibody titer, the detection of circulating antigens (free or in immune complexes) plays an important role in determining the role of streptococci in the formation of immunopathological processes. Modern diagnostics of streptococcal infection is an ELISA and the use of antisera to discrete antigens of Group A streptococci.
[Treatment of streptococcal infection
Treatment of streptococcal infection consists in the use of benzylpenicillin preparations, to which the pathogen retains a high sensitivity. Most strains are also highly sensitive to erythromycin, azithromycin, clarithromycin, oxacillin and oleandomycin.
Treatment of streptococcal infection with signs of invasion consists in the appointment of benzylpenicillin (intravenously or intramuscularly at 2.4 million units every 4 hours) and clindamycin (intravenously or intramuscularly at 0.6-1.2 g every 6 hours). Treatment of STS with antibiotics is not always effective (lethality reaches 50%). Effective normal human immunoglobulin, containing a wide range of neutralizing antibodies to superantigens of streptococci.