Streptococcal Toxic Shock Syndrome: All You Need to Know

Some people are at increased risk

Anyone can get STSS, but there are some factors that can increase your risk of getting this infection.

Age

STSS is most common in adults 65 years old or older.

Infections or injuries that break the skin

People with an open wound are at increased risk for STSS. This can include people who recently had

• Surgery
• A viral infection that caused open sores (such as varicella that causes chickenpox and shingles)

Other health factors

People with diabetes or alcohol use disorder, previously known as alcohol dependence or alcoholism, are at increased risk for STSS.

Many tests, considerations help doctors diagnose STSS

There is no single test used to diagnose STSS. Instead, doctors may:

• Collect blood or other samples to test for group A strep infection
• Order tests to see how well different organs are working

Doctors diagnose STSS when they find group A strep bacteria in a patient who also has:

• Low blood pressure
• Problems with two or more of the following organs:
  • Kidney
  • Liver
  • Lung
  • Blood
  • Skin
  • Soft tissue (tissue beneath the skin and muscles)

STSS needs treatment in a hospital

Doctors treat STSS with antibiotics. People with STSS need care in a hospital. They often need fluids given through a vein and other treatments to help treat shock and organ failure. Many people with STSS also need surgery to remove infected tissue.

Serious complications are common

STSS often results in complications from organs shutting down and the body going into shock, including:

• Limbs removed through surgery
• Severe scarring from having infected tissues removed through surgery

Even with treatment, STSS can be deadly. Out of 10 people with STSS, as many as 3 people will die from the infection.

Prevent STSS

There are no vaccines to prevent group A strep infections, but there are things you can do to help protect yourself and others.

To help prevent group A step infections, you should:

• Clean and care for wounds
• Wash your hands often
• Take antibiotics, if prescribed

Clean and care for wounds

Wash hands often

The best way to keep from getting or spreading group A strep bacteria is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

You should also wash glasses, utensils, and plates after someone who is sick uses them. After they have been washed, these items are safe for others to use.

Take antibiotics, if prescribed

It is very rare for someone with STSS to spread the infection to other people. For this reason, doctors usually do not give preventive antibiotics to people who are under the age of 65 years and in close contact with someone with STSS. People who live together would be an example of close contacts. However, doctors may consider giving antibiotics to close contacts who are 65 years old or older and at higher risk of getting STSS.

Streptococcal Infections (invasive group A strep, GAS)

Last Reviewed: April 2023

What is group A Streptococcus (GAS)?

Group A streptococci are bacteria commonly found in the throat and on the skin. The vast majority of GAS infections are relatively mild illnesses, such as strep throat and impetigo. Occasionally, however, these bacteria can cause much more severe and even life threatening diseases such as necrotizing fasciitis (occasionally described as “the flesh-eating bacteria”) and streptococcal toxic shock syndrome (STSS). In addition, people may carry group A streptococci in the throat or on the skin and have no symptoms of disease.

How are group A streptococci spread?

These bacteria are spread by direct contact with nose and throat discharges of an infected individual or with infected skin lesions. The risk of spread is greatest when an individual is ill, such as when people have strep throat or an infected wound. Individuals who carry the bacteria but have no symptoms are much less contagious. Treatment of an infected person with an appropriate antibiotic for 24 hours or longer eliminates contagiousness. However, it is important to complete the entire course of antibiotics as prescribed. Household items like plates, cups and toys do not play a major role in disease transmission.

What is invasive group A streptococcal disease?

Invasive GAS disease is a severe and sometimes life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle and fat tissue or the lungs. Two of the most severe, but least common, forms of invasive GAS disease are called necrotizing fasciitis (infection of muscle and fat tissue) and streptococcal toxic shock syndrome (a rapidly progressing infection causing low blood pressure/shock and injury to organs such as the kidneys, liver and lungs). Approximately 20 percent of patients with necrotizing fasciitis and 60 percent with STSS die. About 10-15 percent of patients with other forms of invasive group A streptococcal disease die.

What are the early signs and symptoms of necrotizing fasciitis and streptococcal toxic shock syndrome?

Early signs and symptoms of necrotizing fasciitis include fever, severe pain and swelling, and redness at the wound site. Early signs and symptoms of STSS may include fever, dizziness, confusion, low blood pressure, rash and abdominal pain.

How common is invasive group A streptococcal disease?

Approximately 9,000-11,500 cases of invasive GAS disease occur in the United States each year resulting in 1,000-1,800 deaths. The Centers for Disease Control and Prevention estimates that less than 10% of these are cases of necrotizing fasciitis and STSS. In contrast, there are several million cases of strep throat and impetigo annually. Clusters of cases or outbreaks of invasive GAS have not been reported in any schools or communities in New York State.

Why does invasive group A streptococcal disease occur?

Invasive group A streptococcal infections occur when the bacteria gets past the defenses of the person who is infected. This may occur when a person has sores or other breaks in the skin that allow the bacteria to get into the tissue. Health conditions that decrease a person’s immunity to infection also make invasive disease more likely. In addition, there are certain strains of GAS that are more likely to cause severe disease than others. The reason why some strains will cause more severe illness is not totally clear but may involve the production of substances (toxins) that cause shock and organ damage and of enzymes that cause tissue destruction.

Who is most at risk of invasive group A streptococcal disease?

Few people who come in contact with a virulent strain of GAS will develop invasive GAS disease; most will have a routine throat or skin infection and some may have no symptoms whatsoever. Although healthy people can get invasive GAS disease, people with chronic illnesses like cancer, diabetes and kidney dialysis, and those who use medications such as steroids, are at higher risk. In addition, breaks in the skin, like cuts, surgical wounds or chickenpox, may provide an opportunity for the bacteria to enter the body.

Can invasive group A streptococcal disease be treated?

Group A streptococcus bacteria can be treated with common, inexpensive antibiotics. Penicillin is the drug of choice for both mild and severe disease. For penicillin-allergic patients with mild illness, erythromycin can be used, although occasional resistance has been seen. Clindamycin may be used to treat penicillin-allergic patients with more severe illness and can be added to the treatment in cases of necrotizing fasciitis or STSS. Certain other antibiotics also are effective. In addition to antibiotics, supportive care in an intensive care unit and sometimes surgery are necessary with these diseases. Early treatment may reduce the risk of death although, unfortunately, even appropriate therapy does not prevent death in every case.

Should contacts of individuals with invasive group A streptococcal disease be tested and treated?

The risk of secondary cases of invasive GAS disease among persons with casual contact to a case is very small. However, there are occasional reports of close contacts such as family members developing severe disease. In general, it is not necessary for all persons exposed to someone with an invasive group A streptococcal infection to be tested or receive preventive antibiotics. If household contacts are in good health, they should be watched for signs of GAS infection, but will not need to take preventive antibiotics. However, those who are at higher risk of invasive disease if infected (for example, persons with diabetes, cancer, chronic heart disease or alcoholism) should discuss the benefit of preventive antibiotics with their healthcare provider.

What can be done to help prevent invasive group A streptococcal infections?

The spread of all types of group A streptococcal infections may be reduced by good hand washing, especially after coughing and sneezing, before and after preparing foods and before eating. Persons with sore throats should be seen by a physician who can perform tests to find out whether it is strep throat; if so, one should stay home from work, school or daycare for 24 hours or more after taking an antibiotic. All wounds should be kept clean. Wounds should be watched for possible signs of infection which include increasing redness, swelling and pain at the wound site. If these signs occur, especially in a person who also has a fever, consult a doctor immediately.

Streptococcal infections: symptoms, diagnosis and treatment

Contents

• 1 Streptococcal infections: symptoms, treatment and prevention
  • 1.1 Streptococcal infections: what is it?
  • 1.2 Types of streptococcal infections
    • 1.2.1 Streptococcal pharyngitis
    • 1.2.2 Streptoderma
    • 1.2.3 Streptococcal pyodermatitis

  90 005 1.3 Symptoms of streptococcal infections

  • 1.4 Diagnosis of streptococcal infections
  • 1.5 Treatment of streptococcal infections
  • 1.6 Prevention of streptococcal infections
    • 1.6.1 Basic principles
    • 1.6.2 Preventive antibiotic therapy
    • 1.6.3 What should not be done?
  • 1.7 Complications of streptococcal infections
  • 1.8 Streptococcal infections: how dangerous are they?
  • 1.9 Streptococcal infection in children
  • 1. 10 How to protect yourself from streptococcal infections during an epidemic?
  • 1.11 Q&A:
    • • 1.11.0.1 How does streptococcal infection occur?
      • 1.11.0.2 What are the symptoms of a streptococcal infection?
      • 1.11.0.3 How is a streptococcal infection diagnosed?
      • 1.11.0.4 What are the main treatments for streptococcal infections?
      • 1.11.0.5 What are the possible complications of streptococcal infection?
      • 1.11.0.6 What is the prevention of streptococcal infection?
  • 1.12 Related videos:

An article about streptococcal infections – what they are, how they manifest themselves and how to treat them. Learn about the symptoms, diagnosis, and management of the disease.

Streptococcal infections are a group of pathogens that cause a variety of diseases ranging from mild to severe. Diseases caused by streptococci can affect various systems of the body, such as the respiratory, nervous, endocrine, and others. Most streptococcal infections require treatment to be cured, and can be dangerous if not diagnosed and treated appropriately.

The symptoms of streptococcal infections can be varied and vary depending on which particular infection is causing the illness. Sometimes patients with streptococcal infections may not develop symptoms and as a result may not know they have the infection.

To successfully treat streptococcal infections, it is important to obtain an accurate diagnosis. Diagnostic methods may include analysis of swabs from the throat or throat, blood, urine, and other body fluids. When an infection is unequivocally confirmed, a doctor may prescribe appropriate treatment, which may include antibiotics or other medical treatments.

Streptococcal infections: what is it?

Streptococcal infections is a group of diseases caused by the bacteria Streptococcus. These bacteria are popular around the world and can cause a wide range of infections, from mild to serious.

Streptococcal infections can occur in anyone, but children and people with weakened immune systems are especially susceptible. Streptococcus bacteria can be transmitted through coughing and sneezing, as well as contact with objects on which they are present.

Some of the more common streptococci can cause diseases such as stomatitis, pharyngitis, scarlet fever, rheumatic fever, pneumonia, and many others. Symptoms of a streptococcal infection can range from mild to severe and include high fever, sore throat, cough, headache, runny nose, nausea, and vomiting.

Types of streptococcal infections

Yes

66.67%

No

33.33%

Streptococcal pharyngitis

Streptococcal pharyngitis is an infection caused by group A beta-hemolytic streptococci. Typical symptoms of pharyngitis include a sore throat, difficulty swallowing, a red and swollen throat, and lymph nodes in the neck.

To diagnose strep pharyngitis, your doctor may do a physical exam, a strep test, or a throat culture.

Treatment may include antibiotics and drugs to relieve symptoms, such as anti-inflammatory and pain medications.

Streptoderma

Streptoderma is a skin infection caused by streptococci. Often the disease develops in children and manifests itself in the form of a skin rash, itching and burning. Swelling, blisters and a creeping spot may appear later.

Your doctor may do a physical exam and take a skin sample for analysis to confirm a diagnosis of streptoderma. Treatment may include antibiotics and antifungals.

Streptococcal pyodermatitis

Streptococcal pyodermatitis is a skin infection that spreads rapidly and presents as red, swollen pimples and painful sores on the skin.

To diagnose pyoderma, your doctor may take a sample of your skin for analysis and do a physical examination. Treatment usually includes antibiotics and topical agents to relieve symptoms.

Symptoms of streptococcal infections

Streptococcal infections may present with different symptoms depending on the type and location of the infection. The most common symptoms are those of throat and skin infections.

• Throat infections may present with sore throat, large amounts of mucus, difficulty swallowing, and fever.
• Skin infections may present as red spots on the skin, pain and itching in the affected area, and blistering and sores.

In some cases, streptococcal infections can occur without pronounced symptoms, which makes diagnosis difficult and can lead to complications.

If you notice these symptoms in yourself, we recommend that you contact a specialist to identify the cause of the disease and determine the necessary treatment.

Diagnosis of streptococcal infections

Diagnosis of streptococcal infections is based on the clinical manifestations of the disease and laboratory tests.

Clinical diagnosis of is based on symptoms that may include high fever, cough, sore throat, pustular skin rash, abdominal pain, vomiting, and diarrhea. It is important to note that symptoms may vary depending on the type and extent of the infection.

Laboratory diagnosis is carried out using various methods:

1. Bacteriological method, which allows the isolation and identification of infectious agents. To do this, a smear is taken from the affected area or the patient’s blood and seeding is carried out on a nutrient medium. After growing bacterial colonies, they are identified by morphological and biochemical characteristics. You can also use the PCR method to determine the presence of streptococcal DNA.
2. Serological method, which consists in determining the level of antibodies in the patient’s blood. This method is used to diagnose rheumatic conditions caused by streptococci.
3. A rapid diagnostic method that is based on the detection of antigens of the C-group of streptococci in swabs from the patient’s throat. This method is considered less sensitive than bacteriological, but allows for faster diagnosis.

After the diagnosis and detection of streptococcal infection, it is necessary to immediately begin treatment with antibiotics, which must be prescribed by a doctor.

Treatment of streptococcal infections

Streptococcal infections is an inflammatory disease caused by a group of microorganisms known as streptococcus. Treatment for streptococcal infections depends on the type of infection and the severity of the symptoms.

Antibiotics is the main treatment for most streptococcal infections, including pharyngitis, scarlet fever, and streptococcal pneumonia. The duration of a course of antibiotics is usually about 10 days.

Antibiotics for streptococcal infections may include:

• Amoxicillin
• Azithromycin
• Clarithromycin
• Penicillin

over-the-counter medications to relieve symptoms can help during the illness. For example, pain medications such as ibuprofen and paracetamol can lower fever and reduce pain. Sprays and propolis solutions can relieve sore throats.

Attentive care is also part of the treatment of streptococcal infections. It is important to stay in bed and drink enough water so that the body can fight the infection. Washing your hands regularly and avoiding contact with people who are sick can help prevent the spread of the infection.

A visit to the doctor is essential if you suspect a streptococcal infection. Only a qualified medical specialist can diagnose and determine the need for treatment.

Prevention of streptococcal infections

Basic principles

The basis for the prevention of streptococcal infections is to strengthen the body’s immunity.

Additional measures to prevent infection include the following principles:

• Personal hygiene. It is important to wash your hands regularly and use hand sanitizers.
• Avoid contact with sick people. If you are around a sick person, wear a face mask to avoid getting infected.
• Regular ventilation of rooms. This reduces the concentration of bacteria in the air and reduces the risk of infection.
• Proper nutrition. It is important to eat enough fruits, vegetables, protein foods and vitamins in your diet to strengthen your immune system.
• Vaccines. Streptococcal vaccines can be used to prevent certain types of diseases, such as rubella.

Preventive antibiotic therapy

If a family history of streptococcal infections, especially in children, the doctor may recommend a short course of antibiotics to prevent disease. This decision is made by the doctor based on the indications for such treatment and the risk of infection.

What should not be done?

Do not self-administer antibiotics for prophylaxis, consult your doctor instead.

Try to minimize the use of antibiotics as this can lead to the development of associated bacterial resistance problems.

Complications of streptococcal infections

Hemolytic shock. This is the most dangerous complication of streptococcal infections and can be fatal. Shock occurs as a result of damage to the body by toxins secreted by streptococci. The main symptoms: severe weakness, loss of consciousness, lowering blood pressure, pallor of the skin, heart rhythm disturbance.

Pustular complications. The most common complications are ulcers on the skin and soft tissues, in areas of the lungs or abscesses inside the abdominal cavity. The most dangerous abscess is on the neck or in the face, as it can lead to inflammation of the brain. With pustular complications, surgery and antibiotic therapy are required.

Renal insufficiency. Acute streptococcal infection may lead to renal failure. This is due to impaired kidney function due to the action of staphylococcal toxins. Symptoms: lack of urination, swelling, pain in the lumbar region. Hospitalization required.

Rheumatic complications. Appears several weeks after infection and is associated with connective tissue damage. A number of symptoms: joint pain, heart rhythm disturbance, skin rashes. Timely and correct treatment helps to avoid complications.

Streptococcal infections: how dangerous are they?

Streptococcal infections can be dangerous, especially if medical attention is not sought promptly. Attention to the first symptoms is very important, as some types of streptococci can lead to serious complications, including sepsis, pneumonia, meningitis, and heart disease.

Some forms of streptococci, such as group A, can cause various diseases, such as pneumonia, sore throats, and gastrointestinal disorders. They can also lead to complications that can be fatal, including infectious toxic shock (or Thes’ syndrome), endocarditis, and glomerulonephritis.

Regular health checks are required to diagnose streptococcal infections . Rapid detection of the infection can help prevent its spread and prompt treatment. Effective treatment can also prevent complications or reduce their severity.

There are various treatments for streptococcal infections, including antibiotics and drugs to improve immunity and keep you healthy. In some cases, hospitalization may be required.

Contact with patients with treptococcal infections is not safe, because this infection is transmitted by airborne droplets. It is in the interests of human health that one should receive medical care and seek experienced professionals in the first place.

Streptococcal infection in children

Streptococcal infections in children are caused by infection with group A Streptococcus bacteria. This infection can lead to various diseases such as tonsillitis, pharyngitis, scarlet fever and others.

Symptoms of a streptococcal infection in children may include a throat that is red and sore, body temperature, abdominal pain, and vomiting. In the case of scarlet fever, the child may get a rash on the body that resembles a nettle burn.

A medical test for Streptococcus group A antigen is used to diagnose streptococcal infections in children. If the test is positive, treatment may include antibiotics and symptomatic treatment.

In some cases, it is necessary to consult a doctor for advice and treatment. Delay in treating this infection can lead to serious complications such as rheumatic fever or kidney failure.

• Prevention. There are a number of things you can do to prevent streptococcal infections in children. First of all, it is necessary to wash the child’s hands, especially after visiting crowded places. In addition, it is necessary that the child eat right and lead a healthy lifestyle.
• Conclusion. Streptococcal infection in children is a serious illness that requires immediate treatment. If there is a suspicion of this disease, parents should immediately consult a doctor and follow his instructions.

How to protect yourself from streptococcal infections during an epidemic?

Streptococcal infections are infections caused by the bacterium Streptococcus. These infections often appear during epidemics and can lead to a variety of illnesses, including tonsillitis, scarlet fever, skin infections, and even sepsis.

To protect yourself from streptococcal infections during an epidemic, you should take the following steps:

• Maintain personal hygiene: Wash your hands frequently with soap and water for at least 20 seconds. Avoid touching your eyes, nose and mouth.
• Avoid close contact with people who are sick: Avoid close contact with people who have signs of streptococcal infection such as coughing, sneezing or skin festering.
• Keep social distance: Try to stay away from places where there are a lot of people. Avoid large crowds of people, for example, in transport, shopping centers, restaurants, etc.
• Boost your immunity: Maintain a healthy lifestyle, including a healthy diet, regular physical activity and adequate rest.

If you suspect that you or someone close to you has contracted a streptococcal infection, it is important to see a doctor as soon as possible. The sooner you start treatment, the less likely you are to have complications and spread the infection to other people.

Q&A:

How does streptococcal infection occur?

Streptococcal infection is transmitted by airborne droplets, through contact with a sick person, and also through household items touched by a sick person.

What are the symptoms of a streptococcal infection?

Symptoms of streptococcal infection include high fever, purulent compartments, severe sore throat, lymphadenitis, a violation of the general condition of the patient.

How is a streptococcal infection diagnosed?

Bacteriological tests, blood tests, urinalysis and other laboratory tests are used to diagnose streptococcal infections.

What are the main treatments for streptococcal infections?

The main methods of treatment of streptococcal infection are the use of antibiotics, washing the throat, lowering the temperature, maintaining the general condition of the patient.

What complications can occur with streptococcal infection?

Rheumatism, purulent diseases, osteomyelitis, sepsis and other complications that can be life-threatening for the patient can occur as complications of streptococcal infection.

What is the prevention of streptococcal infection?

Prevention of streptococcal infection includes personal hygiene, strengthening immunity, reducing contact with patients, handling household items, proper nutrition and other measures to prevent infectious diseases.

Related videos:

Streptococcal infection: Causes of streptococcal infection, Symptoms, Treatment of diseases caused by streptococcal infection

Streptococcal infection flora. The infection affects the upper skin, mainly the skin of the face, hands, neck, as well as the respiratory organs. Streptococcal infection causes diseases such as streptoderma, pneumonia, glomerulonephritis, vasculitis, tonsillitis, rheumatism, erysipelas, scarlet fever, etc.

Attention!

Here you can choose a doctor who treats Streptococcal Infection If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis.

Causes of streptococcal infections

Symptoms

Diagnosis

Treatment of diseases caused by streptococcal infections

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Streptococcus is a genus of bacterial organisms that is present in the human body. There are more than 15 subtypes of bacteria, but the most common are: alpha, beta and gamma. With an acceptable value of alpha and gamma, streptococci are part of the normal microflora of the gastrointestinal tract, oral cavity, larynx and respiratory system of a person, they do not carry harm to the body. Beta streptococci are dangerous to human health, and they cause a wide range of human diseases.

Hemolytic streptococcus (group A) is a common bacterium found in the body. The predominant number of infections develops precisely due to group A streptococcus. In this regard, a person has a high susceptibility to streptococcus and, accordingly, under favorable conditions for the bacterium, it actively multiplies in the human body. Group A bacteria most often cause:

• angina;
• pharyngitis;
• impetigo;
• face;
• scarlet fever;
• pneumonia;
• glomerulonephritis;
• vasculitis;
• rheumatism;
• bronchitis;
• periodontitis.

Group B streptococcus mainly affects the genitourinary system, since this type of bacteria is found in the urethra in men and in the vagina in women.

Causes of streptococcal infection

A pathogenic bacterium is transmitted in three ways:

• airborne – the spread of infection with saliva and mucus when sneezing, crying, coughing;
• household contact – direct contact with the carrier of the infection, even if he does not show symptoms of diseases, contact with household items in the house and public places;
• sexual – through unprotected intercourse.

The fastest way to spread streptococcus is by airborne droplets, so children who are in a large group (school, kindergarten, various classes) very often succumb to infection.

Streptococcal infection in children develops most often in the cold season (end of autumn, winter). Due to the fact that children do not always observe hand hygiene, they can become infected in almost any environmental condition.

Often streptococcal infection occurs in newborns, this is due to the ability of streptococcus to penetrate into tissues and organs. At the time of childbirth, infection can occur through the amniotic fluid. The infection develops in the first few hours of life and leads to pneumonia, sepsis, and meningitis. The mortality rate with this development of infection is more than 50%.

In children aged 2 to 8 years, streptococcus often causes pneumonia as a complication of a previous infection: whooping cough, influenza, measles, chickenpox. Immunocompromised children who have suffered severe hypothermia are also susceptible to this disease.

Symptoms

In medical practice, in diseases, streptococcal infection is manifested by a variety of symptoms. It depends on the specific disease that this type of pathogenic bacterium caused.

For the group of diseases of the respiratory tract, these are:

• sore throat;
• temperature increase;
• plaque formation with pus on tonsils;
• swollen lymph nodes.

Streptococcal skin infection is usually accompanied by: inflammatory processes on the skin;

• itching;
• redness;
• the appearance of vesicles, plaques on the skin;
• temperature increase;
• chills;
• weakness.

Diseases of the genitourinary system caused by hemolytic streptococcus are most often asymptomatic. However, there may also be symptoms similar to those of diseases in this area:

• itching;
• selection;
• soreness in the organs of the genitourinary system.

Diagnosis

To identify the bacterium of the genus Streptococcus, a number of tests are carried out that allow you to determine the specific causative agent of the infection, its type and sensitivity to medicines. Traditionally, doctors (the specialty of which depends on the affected area or organ) conduct a comprehensive diagnosis:

• bacteriological examination (inoculation of biological material) – a swab from the tonsils, foci on the skin, sputum examination on the lungs;
• general analysis of urine, blood;
• microbiological examination for the level of sensitivity to antibiotics;
• examination of the affected organs by a narrow specialist.

Treatment of diseases caused by streptococcal infection

Treatment of streptococcal infection requires an initial correct diagnosis of the underlying disease, its differentiation from similar diseases.

When diagnosing the pathogenic bacterium streptococcus, treatment should be carried out by a narrow specialist depending on the affected organ: pulmonologist, dermatologist, gynecologist, urologist, etc.