Streptococcus pyogenes - Revision history

Aidan: /* Microbiology */

2026-02-24T23:57:16Z

Microbiology

← Older revision		Revision as of 23:57, 24 February 2026
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	*[[Stain::Gram-positive]] [[Shape::coccus]], typically in short chains		*[[Stain::Gram-positive]] [[Shape::coccus]], typically in short chains
	*Non-motile, non–spore forming, catalase [[Catalase::negative]], and facultatively anaerobic		*Non-motile, non–spore forming, catalase [[Catalase::negative]], and facultatively anaerobic
	*[[Hemolysis pattern::β hemolytic]] on blood agar (complete hemolysis)		*[[Hemolysis pattern::beta-hemolytic]] on blood agar (complete hemolysis)
	*Can be distinguished from other β-hemolytic streptococci by its susceptibility to [[bacitracin]]		*Can be distinguished from other β-hemolytic streptococci by its susceptibility to [[bacitracin]]

Aidan: /* Classification of Invasive Disease */

2025-07-28T13:03:26Z

Classification of Invasive Disease

← Older revision		Revision as of 13:03, 28 July 2025
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	===Probable Case===		===Probable Case===

	*'''Clinical evidence''' of invasive disease in the absence of another identified aetiology and with non-confirmatory laboratory evidence of infection:		*'''Clinical evidence''' of invasive disease (see below) in the absence of another identified aetiology and with non-confirmatory laboratory evidence of infection:
	**Isolation of group A streptococcus from a non-sterile site, or		**Isolation of group A streptococcus from a non-sterile site, or
	**Positive group A streptococcus antigen detection		**Positive group A streptococcus antigen detection

	===Clinical Evidence===		==== Clinical Evidence ====

	*[[Streptococcal toxic shock syndrome]], which is characterized by hypotension (systolic blood pressure ≤ 90 mm Hg in an adult and < 5 percentile for age for children) and at least two of the following signs:		*[[Streptococcal toxic shock syndrome]], which is characterized by hypotension (systolic blood pressure ≤ 90 mm Hg in an adult and < 5 percentile for age for children) and at least two of the following signs:
	**Renal impairment (creatinine level ≥ 177 μmol/L for adults)		**Renal impairment (creatinine level ≥ 177 μmol/L for adults)
	**Coagulopathy (platelet count ≤ 100,000/mm3 or disseminated intravascular coagulation)		**Coagulopathy (platelet count ≤ 100,000/mm3 or disseminated intravascular coagulation)
	**Liver function abnormality (~~SGOT, SGPT~~, or total bilirubin ≥ 2x upper limit of normal)		**Liver function abnormality (ALT/AST, or total bilirubin ≥ 2x upper limit of normal)
	**Adult respiratory distress syndrome		**Adult respiratory distress syndrome
	**Generalized erythematous macular rash that may desquamate		**Generalized erythematous macular rash that may desquamate
	**Soft-tissue necrosis, including necrotizing fasciitis, myositis or gangrene		*Soft-tissue necrosis, including necrotizing fasciitis, myositis or gangrene
	**Meningitis		*[[Bacterial meningitis\|Meningitis]]
			*Death

	== Diagnosis ==		== Diagnosis ==

Aidan: /* Prevention */

2023-06-08T22:26:44Z

Prevention

← Older revision		Revision as of 22:26, 8 June 2023
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	*Prophylaxis is indicated for '''close contacts''' of a case of '''severe''' invasive group A streptococcal infection; specifically:		*Prophylaxis is indicated for '''close contacts''' of a case of '''severe''' invasive group A streptococcal infection; specifically:
	**Exposure between 7 days before symptom onset to 24 hours after starting antimicrobial treatment		**Exposure between 7 days before symptom onset to 24 hours after starting antimicrobial treatment
	**Severe infections include toxic shock syndrome, necrotizing skin and soft tissue ~~infections~~, meningitis, pneumonia, other life-threatening conditions, or a confirmed case resulting in death		**Severe infections include [[Streptococcal toxic shock syndrome\|toxic shock syndrome]], [[necrotizing skin and soft tissue infection]], [[Bacterial meningitis\|meningitis]], [[pneumonia]], other life-threatening conditions, or a confirmed case resulting in death
	**Close contacts include:		**Close contacts include:
	***Household contacts who have spent at least 4 hours/day on average in the previous 7 days or 20 hours/week		***Household contacts who have spent at least 4 hours/day on average in the previous 7 days or 20 hours/week
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	*Highest risk of streptococcal [[toxic shock syndrome]] (TSS) or death		*Highest risk of streptococcal [[toxic shock syndrome]] (TSS) or death
	**[[Necrotizing fasciitis]] (50% and 50%)		**[[Necrotizing fasciitis]] (50% and 50%)
	**Pneumonia (30% and 30%)		**[[Pneumonia]] (30% and 30%)
	**Bacteremia (15% and 25%)		**[[Streptococcus bacteremia\|Bacteremia]] (15% and 25%)

	{{DISPLAYTITLE:''Streptococcus pyogenes''}}		{{DISPLAYTITLE:''Streptococcus pyogenes''}}

Aidan at 17:31, 5 May 2023

2023-05-05T17:31:46Z

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 * Typically by traditional bacteriology/culture
-=== Antistreptolysin O ===
+=== Serology ===
 === Rapid Antigen Detection Test ===

Aidan: /* Antistreptolysin O */

2023-05-05T17:20:51Z

Antistreptolysin O

← Older revision		Revision as of 17:20, 5 May 2023
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	** Active [[viral hepatitis]]		** Active [[viral hepatitis]]
	** [[Monoclonal gammopathy]]		** [[Monoclonal gammopathy]]
	* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] (PMID [https://pubmed.ncbi.nlm.nih.gov/22338301/ 22338301] for review		* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] (PMID [https://pubmed.ncbi.nlm.nih.gov/22338301/ 22338301]) for review

	=== Rapid Antigen Detection Test ===		=== Rapid Antigen Detection Test ===

Aidan: /* Antistreptolysin O */

2023-05-05T17:20:41Z

Antistreptolysin O

← Older revision		Revision as of 17:20, 5 May 2023
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	** Active [[viral hepatitis]]		** Active [[viral hepatitis]]
	** [[Monoclonal gammopathy]]		** [[Monoclonal gammopathy]]
	* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] for review		* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] (PMID [https://pubmed.ncbi.nlm.nih.gov/22338301/ 22338301] for review

	=== Rapid Antigen Detection Test ===		=== Rapid Antigen Detection Test ===

Aidan at 15:47, 4 May 2023

2023-05-04T15:47:25Z

← Older revision		Revision as of 15:47, 4 May 2023
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	** [[Monoclonal gammopathy]]		** [[Monoclonal gammopathy]]
	* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] for review		* See [https://doi.org/10.2143/ACB.66.6.2062604 10.2143/ACB.66.6.2062604] for review

			=== Rapid Antigen Detection Test ===

			* Used for diagnosing group A streptococcal pharyngitis
			* Specificity 95% and sensitivity 70-90%
			* False positives with GAS colonization/carriage

	==Management==		==Management==

Aidan: /* Microbiology */

2021-08-31T12:39:34Z

Microbiology

← Older revision		Revision as of 12:39, 31 August 2021
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	===Microbiology===		===Microbiology===

	*[[Stain::Gram-positive]] coccus, typically in short chains		*[[Stain::Gram-positive]] [[Shape::coccus]], typically in short chains
	*Non-motile, non–spore forming, catalase [[Catalase::negative]], and facultatively anaerobic		*Non-motile, non–spore forming, catalase [[Catalase::negative]], and facultatively anaerobic
	*[[Hemolysis pattern::β hemolytic]] on blood agar (complete hemolysis)		*[[Hemolysis pattern::β hemolytic]] on blood agar (complete hemolysis)

Aidan: /* Antistreptolysin O */

2021-08-10T13:05:21Z

Antistreptolysin O

← Older revision		Revision as of 13:05, 10 August 2021
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	* Detects prior infection with or exposure to ''Streptococcus pyogenes''		* Detects prior infection with or exposure to ''Streptococcus pyogenes''
			* Used most often for diagnosis of [[acute rheumatic fever]], and far less useful for [[streptococcal pharyngitis]] and [[post-streptococcal glomerulonephritis]]
	* False negatives:		* False negatives:
	** Sample collected during latency period		** Sample collected during latency period

Aidan: /* Management */

2021-08-10T13:03:07Z

Management

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 **Soft-tissue necrosis, including necrotizing fasciitis, myositis or gangrene
 **Meningitis
 ==Management==