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Streptococcus Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy The genus Streptococcus is made up of a wide variety of both pathogenic and non-pathogenic gram-positive bacteria found to inhabit a wide range of hosts, including humans, horses, pigs and cows. Within the host, streptococci are often found to colonize the mucosal surfaces of the mouth, nasal passages and throat. However, in certain circumstances, they may also inhabit the skin, heart or muscle tissue.

Pathogenic streptococci of man include S. pyogenes, S. pneumoniae, and S. faecalis. Among the pathogenic hemolytic streptococci, S. pyogenes, or group A streptococci, has been implicated as the etiologic agent of acute pharyngitis ("strep throat"), impetigo, rheumatic fever, scarlet fever, glomerulonephritis, and invasive fasciitis.

Streptococcus pyogenes is one of the most frequent causes of bacterial disease in humans. Around 10% of normal individuals have the bacterium, usually in the respiratory tract, without signs of disease. As normal flora, S. pyogenes can infect when immunological defenses are down or when the organisms are able to overcome the ususal defenses. When the bacteria gain a foothold to vulnerable tissues, a variety of types of suppurative infections can occur.

In the last century, infections by S. pyogenes claimed many lives. The organism was the most important cause of puerperal fever (systemic infection after childbirth). Scarlet fever was formerly a common and serious complication of streptococcal infection, but because of antibiotic therapy it is almost never more than pharyngitis accompanied by rash. Likewise, erysipelas, a form of cellulitis accompanied by fever and systemic toxicity, is less common today. However, there has been a recent increase in variety, severity and sequelae of Streptococcus pyogenes infections, including a resurgence of severe invasive infections prompting descriptions of "flesh eating bacteria" in the news media. The reason for the decline and resurgence is unknown. Today, the S. pyogenes is of major concern because of the occasional rapid progression of the disease and because of the small risk of serious consequences of untreated infections.

These diseases remain a major worldwide health concern and effort is being directed toward clarifying the risk and mechanisms of these sequelae and identifying strains assocuated with rheumatic fever and nephritis.

The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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