Streptococcus is a genus of gram-positive coccus or spherical bacteria that belongs to the family Streptococcaceae, within the order Lactobacillales, in the phylum Firmicutes. Cell division in streptococci occurs along a single axis, so as they grow, they tend to form pairs or chains that may appear bent or twisted
21. SORE THROAT OR PHARYNGITIS
Most common of all Strep
diseases
Spread by saliva or nasal
secretions
Incubation period 2-4 days
Sore throat, slight fever (101)
Important to treat immediately to
avoid post strep diseases
22. Streptococci adhere to the
pharyngeal mucosa
By means of lipoteichoic acid
covering the surface pili
Multiplication occur
Streptococci may spread to
the surrounding tissues
leading to suppurative
complications
25. IMPETIGO OR PYODERMA
Found mainly in young children
Affecting face, arms, legs & other
exposed parts of the body
Localized infection of skin
Vesicles appear on the skin later
become purulent with honey
coloured crust
26. SCARLET FEVER
If the strain of S. pyogenes is
lysogenic for a particular
phage which expresses an
erythrogenic toxin the result
is Scarlet fever
Rash appears and
characteristic is the
27.
28. Penicillin G or Erythromycin
are drugs of choice
Although the disease is self-
limiting, it is important to treat
immediately to avoid post
strep complications
29. CELLULITIS
Infection of skin and subcutaneous
tissues
Characterized by –
-local inflammation
-edema
-erythema
-tenderness
-fever
30. NONSUPPURATIVE COMPLICATIONS
Rheumatic Fever-autoimmune
disease involving heart valves,
joints, nervous system.
Acute glomerulonehritis or Bright’s
Disease-inflamatory disease of renal
glomeruli and structures involved in
blood filter of kidney. Due to
deposition of Ag/Ab complexes
31. RHEUMATIC FEVER
Most common cause of
permanent heart valve damage in
children
Exact cause not yet known but
there appears to be some
antibody cross reactivity between
the cell wall of S. pyogenes and
heart muscle
32. GLOMERULAR NEPHRITIS
Diagnosis based on history of
Strep throat and clinical findings.
Symptoms include fever, malaise,
edema, hypertension and blood
or protein in urine
Occurs in 0.5% of those having
strep throat.
33. VIRULENCE FACTORS
Streptokinase:-
a proteolytic enzyme which lysis
fibrin
Hyaluronidase:-
spreading factor- breakdown of
connective tissues
DNAs:-
destroy DNA
35. LABORATORY DIAGNOSIS
Diagnosis of acute suppurative
infection is made by culture while
in the non suppurative
complications, diagnosis is
mainly based on the
demonstration of antibodies.
36. DIAGNOSIS OF ACUTE SUPPURATIVE INFECTIONS
1. Specimens collection: swab, pus, blood
or CSF
2. Collection & transport: in sterile
container, culture immediately or sent to
the lab. In Pike’s transport medium.
3. Gram‘s staining of the smears: Gram’s
positive cocci in chains
4. Culture: inoculated on blood agar &
incubate at 37°C for 18-24 h… β
haemolytic
37. 5. Colony morphology & staining: colonies
are small (0.5-1.0 mm) pin point colonies
Circular, low convex, β haemolytic
In liquid media- granular turbidity with
powdery deposit
Hanging drop preparation shows non
motile
6. Biochemical reactions: catalase negative
7. Identification of various groups of
streptococci: gp. A are more sensitive to
bacitracin.
8. Lancefield grouping: by serologically
38. DIAGNOSIS OF NON SUPPURATIVE COMPLICATIONS
By serological tests– the routine test done
is ASO (antistreptolysin O) titration
A titre of 200 units or more is significant in
rheumatic fever
For glomerulonephritis anti DNAs B
estimation is more reliable with titre
higher than300 0r 350
39. TREATMENT & PREVENTION
Penicillin (drug of choice)
Erythromycin (for hypersensitive
patients)
No vaccine is available
40. ORAL STREPTOCOCCI
Live in oropharynx
Mixed group of organisms
α- haemolytic on blood agar
Divided into 4 species groups-
mutans gp.
salivarius gp.
anginosus gp.
mitis gp.
41. 1. Mutans group-
S. mutans
S. sobrinus
S. cricetus
S. rattus
2. Salivarius group-
S. salivarius
S. vestibularis
42. 3. Anginosus group-
S. intermedius
S. anginosus
4. Mitis group-
S. sanguis
S. gordonii
S. parasanguis
S. oralis
43. • They makeup a large proportion
of resident oral flora
• One-quarter of the total
cultivable flora from
supragingival & gingival plaque
• Half of the isolates are from the
tongue and saliva
• They are transmitted from
mother to child
47. PATHOGENICITY
They causes dental caries
But in absence of predisposing
factors, such as sucrose, they can
not cause caries
They have ability to produce
extracellular polysaccharides in the
presence of dietary carbohydrates
48. That help binding of the
organism to enamel and to each
other
They may also cause infective
endocarditis, as a result of their
entry into the bloodstream during
intraoral surgical procedures
(tooth extraction)
50. DENTAL CARIES
Chronic endogenous infection
Caused by the normal oral flora
The carious lesion is the result of
demineralization of enamel &
later of dentine, by acids
produced by plaque m/o, as they
metabolize carbohydrates.
51. TREATMENT & PREVENTION
In patient at risk of infective
endocarditis, prophylactic
antibiotic should always be
given before dental
procedures.