Bacteria: Streptococcus

M PROTEINS

facilitate spread through host tissue. AntiB’s can use M proteins to mark- weak point.

Adhesins

Capsule

Exotoxins (many- some are superantigen)

Proteins (many that inactivate AntiB’s)

EXUDATIVE PHARYNGITIS

(most common- strep throat)

Non-suppurative: fever, glomerulonephritis

Suppurative: abscesses, otitis media, sinusitis

Other: skin, soft tissue infection, sepsis, pneumonia. Skin findings can overlap with staph

PENICILLIN

Natural:

Penicillin G

Penicillin VK

If between strep or staph, need broad spectrum AntiB

Neonates: fever, high risk for blindness, deafness, neurologic developmental delays

#1 cause of neonatal meningitis / sepsis

Prompt treatment with AntiB’s reduce mortality, still has high risk of neurologic sequelae

Pregnancy screens before delivery, if positive, given AntiB’s before birth

PENICILLIN

Recent viral illness

Children / elderly

Immunocompromised

Respiratory droplets, colonization in naso/oropharynx

Endogenous spread from colonized to distal sites

#1 cause of sinusitis, otitis media, pneumonia, meningitis and suppurative conjunctivitis

Bacteremia common

VACCINES:

Conjugated (kids- add protein for T cell response)

Polysaccharide (adults- stimulate mature antibodies)

MULTI-DRUG RESISTANCE (DRSP)

To penicillins and other B-lactams

Increase dose

Common cause of bacterial endocarditis (native valve)

Development of dental cavities