Diseases

Streptococcal infection - causes, symptoms, contagion

Streptococcal infection - causes, symptoms, contagion


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Streptococci are a group of bacteria, the species of which haunt us as pathogens for various diseases and mainly settle on the mucous membranes. Infection with streptococci is usually not the first disease, because the bacteria can only spread in the body when the immune system is down.

What do streptococci do?

Streptococci usually enter the body through droplets or touches by an infected person. Depending on the pathogen, they trigger inflammation of the tonsils and palate, for example, but can even ignite the heart and lungs. Then the bacteria sometimes endanger life. Strictly speaking, the diseases do not arise through the streptococci themselves, but through their excretions. Without treatment, the bacteria spread in the body and consequential diseases arise. The incubation period is between 3 days and two weeks.

What types of streptococci are there?

Streptococcus pyogenes means "triggering pus". This species mainly enters the body through the oral mucosa and triggers scarlet fever, tonsillitis and throat infections. The reactions of the immune system to these bacteria are more problematic. These “cross reactions” can cause inflammation of the skin and joints as well as the muscles and the heart.

Streptococcus pneumoniae primarily affects the mucous membranes of the respiratory tract and typically triggers pneumonia. But these bacteria can also cause meningitis, otitis media, sinusitis and corneal inflammation of the eyes.

Streptococcus mutans is a species that almost everyone comes into contact with. It causes tooth decay. The excretions of these streptococci contain acid, which damages the tooth surface. This creates holes in the teeth. Streptococcus mutans also causes inflammation of the teeth, gums and tongue.

Danger to the unborn child

The bacteria pose a risk to fetuses if they rise from the genital area to the amniotic cavity in the uterus. Pregnant women should therefore avoid all possibilities of getting streptococcal infections.

How do you become infected with streptococci?

Streptococci are transmitted through a droplet or smear infection. They are common and we usually always have a small number of these bacteria in our bodies. Problems only arise when your immune system is weakened, whether due to a chronic illness, whether it is due to a recent operation or an innate immune deficiency.

Immediately preceding diseases also shift the forces between the immune system and streptococci. This can already be a flu-like infection, but especially serious illnesses such as glandular fever or tumors. Drug and alcohol abuse weaken the immune system to such an extent that the pathogens can nestle in the body. Not only can you reproduce better now, but a small amount of the bacteria can trigger an illness.

A weak immune system is particularly the cause of streptococcal infections, which are located in the area of ​​the respiratory tract and body openings, i.e. inflammation in the ear, nose and throat area, in the throat, on the tonsils and the paranasal sinuses.

Contaminated surfaces

The bacteria are also on uncleaned surfaces, on taps, door handles or on tram seats. If food is not stored sterile enough, it can also contain streptococci. However, even when properly stored, they are transmitted when one of them attacks the food with their hands. In contrast to droplet infection, prevention is simple here: wash your hands when you have touched possible contaminated surfaces and wash food thoroughly.

Lack of hygiene

This passes into the third risk, namely poor hygiene. In order to become infected with streptococci, it is sufficient to wipe the nose with bacteria-laden hands or to scratch the gums. You can avoid this risk by washing your hands regularly.

Kissing, sneezing and coughing

Because streptococci also spread through droplets, you can also become infected by being close to the sick. It doesn't even have to be the kiss of an infected partner. It is enough for an infected person to sit and sneeze across the streetcar from them. Streptococci in water droplets in particular can travel long distances with the air. If you are infected yourself, be sure to sniff or sneeze into a cloth; if someone else is sneezing or sniffing, cover your nose and mouth with a cloth.

Open wounds invite streptococci and other bacteria. On the one hand, the immune system is fully occupied, on the other hand, there is direct access to the body. Therefore, be sure to disinfect and cover a wound immediately.

Different symptoms

Streptococcal infections are "tricky". On the one hand, the different types of bacteria trigger different symptoms, on the other hand, these symptoms are non-specific and can only be recognized in their entirety as being caused by streptococci.

Streptococcus pyogenes looks slightly more harmless than it can be: The “classic” symptom here is tonsillitis. But the tonsils, a kind of protective wall for the vital organs inside the body, ignite for a variety of reasons. Their job as a “dirt filter” means that they often catch fire. Nothing in evolution is perfect, and it is evident from the fact that almonds are often so damaged by the substances they intercept that they ignite again and again. The diagnosis of “tonsillitis” can be an indication of streptococci, but it does not have to be.

The common symptoms of streptococcal infection also occur in other infectious diseases, bacterial and viral infections. This includes fatigue, fever, high blood pressure, body aches, sore throat and headache. Other possible symptoms include earache, redness, swelling, irregular heartbeat, dizziness, chills, malaise, general weakness, nausea and vomiting.

Blood poisoning and necrosis

This uncertainty would also not be dramatic if it were just a tonsillitis. But Pyogenes spreads well in the blood, so the inflammation of the tonsils and throat is easily followed by a flood of bacteria in the bloodstream. Now it gets serious, because once in the blood, the pathogens can trigger systemic diseases - even blood poisoning, an inflamed heart or tissue necrosis, which lead to death.

Bark lichen

Pyogenes can infect the skin as well as the subcutaneous tissue, muscles and fascia. The contagious bark lichen is typical, especially on the mouth, nose and legs. Pustules form, these break open and lead to crusting (scab).

Scarlet fever

We know scarlet fever as an independent disease, but it is a streptococcal infection that shows up as an exanthema that is caused by a poison of the bacterial excretions.

The disease manifests itself in small blotchy papules that appear on the upper body on the first day of the disease and spread everywhere except for the palms of the hands and soles of the feet. The patients are pale, their tongues turn characteristic raspberry red. The rash disappears after about a week, after which the skin scales.

Scarlet fever traditionally came close to measles, rubella and chickenpox due to its symptoms, and was considered a typical childhood disease. However, unlike these other infections, a disease does not lead to long-term immunization. The immune system only repels streptococci, multiple infections with scarlet fever are possible at any time.

The toxic shock

Streptococcal toxic shock syndrome also arises from the toxins in the excretions. Here there is a shock and multi-organ failure. Every third affected person dies. If a toxic shock is indicated, immediate treatment in the intensive care unit is necessary.

B streptococci

B-streptococci are in the vagina of every third pregnant woman without the expectant mothers being sick. In the newborn, who has not yet developed an immune system, an illness can occur. There is a risk of meningitis.

At the end of pregnancy (35th to 37th week), the gynecologist can detect the bacteria using a smear from the vagina or rectum. The affected person then receives an antibiotic, usually penicillin. Since the pathogens are usually present in small quantities, one or two ingestions are usually sufficient.

Diagnosis

In order to recognize the bacteria, a detailed discussion between doctor and patient is necessary. It is about the specific pain and symptoms. Then the doctor searches the body for visual changes: is the skin red? The mouth? Are almonds or lymphs swollen? Or the ear?

If the doctor now suspects streptococci, he takes a blood or saliva sample, on which the corresponding type of bacteria can be detected in the laboratory. First, the doctor usually runs a rapid antigen test. An infection with streptococci from serogroup A shows a positive result. Exactly what type it is can only be determined by a special laboratory, but this is irrelevant for the treatment.

Treatment for streptococci

Streptococci are bacteria and can therefore be treated with antibiotics. These are the first choice when the pathogens have settled in the body. There are antibacterial ointments and creams for skin infections. The antibiotics mainly contain penicillin, clarithromycin or erythromycin.

Pyogenes is not resistant to penicillin in Germany. Therefore, a 10-day administration of penicillin is effective against infections in the throat and skin. If patients are allergic to penicillin, cephalosporins, erythrmycin or other macrolides are an alternative. They should also be taken up to 10 days. However, in 38% of treatments, Pyogenes is resistant to erythromycin. In the event of toxic shock, sepsis or tissue necrosis, clindamycin is necessary in addition to penicillin.

The symptoms of streptococcal inflammation on the palate, throat or tonsils can be relieved by medication for sore throats. Sage tea and salt water are effective home remedies for sore throats.

You should go to the doctor early, because a beginning infection with streptococci can be treated well. The pathogens are usually destroyed within a few days. An advanced infection can mean sepsis or even death.

Frequency of the disease

Throat infections caused by Pyogenes are among the most common bacterial infections in children between 6 and 12 years of age. In Germany there are probably up to 1.5 million infections a year. In most cases, these remain unproblematic and many sufferers perceive this as a flu infection or short fever.

Purulent skin inflammation caused by streptococci is particularly common in the tropics and subtropics, especially in young children. Due to the high humidity, bacteria can collect well on the skin, inadequate hygienic conditions and poverty also offer the pathogens a breeding ground. The immune system of the affected toddlers is often weakened beforehand by other diseases and malnutrition, clean water and sterile food are lacking. The bacteria can also spread very well through the coexistence of people in a confined space.

Legal provisions

The Infection Protection Act prohibits people who are infected with Streptococcus pyogenes from working in community facilities in the care, education, supervision and any other area in which they have contact with those cared for there. The doctor decides when there is no longer a risk of transmitting the disease. With antibiotic therapy, you can go back to work on the second day when there are no more symptoms.

During the infection, those affected must not enter or use the community facilities and must not take part in events.

Section 42 of the Infection Protection Act applies to skin diseases caused by streptococci. Affected persons are not allowed to carry out any activities during the infection where they come into contact with food, in supermarkets or in the catering or kitchen sector, while producing or transporting food.

Heads of community facilities are required to notify the health department if a scarlet fever or other streptococcal infection occurs in their facility.

Special risk groups

Streptococcal infections are particularly dangerous for patients suffering from HIV or diabetes. Here, the excretions of the bacteria can trigger a septic shock. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch

Swell:

  • Robert Koch Institute: Streptococcus pyogenes infections (accessed: August 6, 2019), rki.de
  • Merck & Co., Inc .: Streptococcal infections (accessed: August 6, 2019), msdmanuals.com
  • Professional Association of Pediatricians e. V .: Scarlet fever (retrieval: 06.08.2019), kinderaerzte-im-netz.de
  • Amboss GmbH: Diseases caused by streptococci (accessed: August 6, 2019), amboss.com
  • U.S. National Library of Medicine: Streptococcal Infections (accessed: August 6, 2019), medlineplus.gov
  • Mayo Clinic: Strep throat (accessed: August 6, 2019), mayoclinic.org
  • Cleveland Clinic: Group A Streptococcal Infections (accessed: August 6, 2019), my.clevelandclinic.org
  • Centers for Disease Control and Prevention (CDC): Group A Streptococcal (GAS) Disease (accessed: August 6, 2019), cdc.gov

ICD codes for this disease: A38, A40, A49, G00, J02, J03, J15, J20 ICD codes are internationally valid encryption codes for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: Group A Streptococcus GAS: Symptoms u0026 Other Clinical Features Infectious Diseases. Lecturio (January 2023).