Streptococcal infections refer to a variety of diseases caused by bacteria of the genus Streptococcus, with the most common types being Group A streptococcal infections and Group B streptococcal infections. These bacteria can cause a range of symptoms from mild skin infections to severe systemic diseases, making them an important source of infections that require close monitoring in global public health. Understanding their transmission routes, characteristic symptoms, and treatment methods can aid in early detection and control, preventing the occurrence of complications.
The diversity of streptococcal infections is clinically manifested in different types of infections such as respiratory, skin, and neonatal infections. Transmission occurs through person-to-person contact, droplet infection, and vertical transmission, thus special precautions are needed in households, healthcare facilities, and childcare settings. Modern medicine has developed rapid diagnostic techniques and antibiotic treatment regimens, but patients must strictly adhere to medical instructions to avoid the spread of antibiotic resistance.
The causes of streptococcal infections are primarily related to the biological characteristics of the bacteria and the immune status of the host. Group A streptococcus (GAS) is most commonly associated with pharyngitis and erysipelas, with its bacterial surface M protein allowing it to evade detection by the immune system. Group B streptococcus (GBS) is more commonly seen in neonatal sepsis and meningitis, primarily transmitted through contact during childbirth. Invasive bacterial infections are usually associated with skin wounds, surgical wounds, or mucosal injuries, allowing the bacteria to directly invade tissues.
Risk factors include:
Symptoms vary based on the site of infection and the type of bacteria. Patients with pharyngitis typically present with redness and swelling of the throat, pain during swallowing, and fever, with some cases showing the formation of pseudomembranes around the tonsils. Skin infections such as erysipelas can lead to red, swollen, and painful skin lesions, with well-defined erythema often appearing on the lower limbs. Neonatal GBS infections may present with non-specific symptoms such as rapid breathing and unstable body temperature, requiring laboratory tests for confirmation.
Patients with toxic shock syndrome may experience rapid fever, low blood pressure, and skin peeling; necrotizing fasciitis is accompanied by rapid tissue necrosis and severe pain. Patients with chronic kidney disease may develop acute glomerulonephritis due to recurrent infections, presenting as hematuria and edema. Differences in symptoms among various infection types require comprehensive interpretation through clinical examination and laboratory data.
The diagnostic process typically involves three stages: first, clinical symptom assessment, where the physician observes the extent of skin inflammation, degree of throat redness, and fever status. The second stage involves rapid antigen testing, using throat secretions for antigen detection, with results available within minutes. If clinical suspicion remains but the rapid test is negative, bacterial culture is needed in the third stage to confirm the diagnosis.
For suspected invasive infections, the following may be required:
Antibiotic treatment is the primary therapy, with penicillin G or cephalosporins as the first choice for Group A streptococcal infections, typically for a duration of 10 days. Severe cases may require intravenous antibiotics, such as a combination of penicillin G and polymyxin for endocarditis patients. During treatment, strict adherence to medication instructions is necessary, as incomplete courses may lead to complications such as hemolytic streptococcal nephritis.
Neonatal GBS infections require treatment with ampicillin and gentamicin in combination. For those allergic to penicillin, clindamycin or macrolide antibiotics may be used, but caution is needed as their efficacy may be lower. Supportive treatment includes antipyretics to control fever and fluid replacement to maintain fluid balance; severe cases may require monitoring in an intensive care unit.
Preventive measures should be designed for different types of infections. In terms of contact prevention, individuals in contact should wash their hands frequently and avoid sharing personal items, while healthcare workers should thoroughly clean instruments after contact with patients. In vaccine development, GBS vaccines have been included in the vaccination programs for pregnant women in some countries, playing a key role in reducing the infection rate in newborns.
Daily protective measures include:
Immediate medical attention is required in the following situations: fever exceeding 38.5°C lasting for 48 hours, sore throat accompanied by difficulty swallowing, rapidly expanding areas of skin redness and swelling, or newborns showing rapid breathing and decreased vitality. Patients with chronic diseases should seek medical attention within 24 hours of symptom onset to prevent the development of complications.
Emergency symptoms that require immediate medical attention include: confusion, appearance of bruises or purpura on the skin, difficulty breathing, and sudden drops in blood pressure as signs of shock. For immunocompromised patients who have undergone organ transplants or chemotherapy, even mild symptoms should be taken seriously, as infections can worsen rapidly.
After contact, thoroughly clean the contact area with soap immediately and avoid sharing personal items such as towels or utensils. If the contact person has open wounds, it is advisable to cover them with dressings. If symptoms such as fever or throat redness appear in the contact person, seek medical attention promptly; the physician may prescribe prophylactic antibiotics as needed.
Can I stop taking antibiotics early if my symptoms improve during treatment?Even if symptoms disappear, the full course of antibiotic treatment should be completed to avoid incomplete bacterial clearance, which can lead to recurrent infections or complications (such as rheumatic fever). If severe side effects (such as allergies) occur after taking the medication, stop immediately and contact the physician to adjust the treatment plan.
Could the appearance of a rash and itching on the skin indicate a Group A streptococcal infection?Yes, Group A streptococcus can cause "streptococcal dermatitis," characterized by red, swollen, and painful skin lesions, which may be accompanied by a low fever. If the surrounding area of skin ulcers spreads or is accompanied by fever, seek medical attention as soon as possible; the physician may perform a culture to confirm the diagnosis.
How long after contact with a patient might symptoms appear?Symptoms typically appear 2 to 5 days after contact, but the incubation period can be as short as 24 hours or as long as 10 days. If symptoms such as sore throat, fever, or skin rash occur within a week after contact, suspicion of infection should be raised, and medical examination should be conducted promptly.
Do I need immediate treatment for mild symptoms like low fever and throat discomfort?Even with mild symptoms, if infection is confirmed through rapid screening or culture, antibiotics should still be taken on time to prevent complications (such as nephritis or myocarditis). The physician will adjust the treatment dosage and schedule based on the severity of the infection; treatment should not be neglected due to mild symptoms.
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