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