Group A streptococcus, pyoderma, and rheumatic fever

The Lancet ◽  
1996 ◽  
Vol 347 (9010) ◽  
pp. 1271-1272 ◽  
Author(s):  
JonathanR. Carapetis ◽  
BartJ. Currie
Keyword(s):  
Rheumatic Fever ◽  
Group A Streptococcus ◽  
Group A

Immunopathological mechanisms in bacterial-host interactions

1983 ◽  
Vol 303 (1114) ◽  
pp. 177-187 ◽  
Keyword(s):  
Rheumatic Fever ◽  
Group A Streptococcus ◽  
Biological Properties ◽  
Antigenic Determinants ◽  
Bacterial Host ◽  
Poststreptococcal Glomerulonephritis ◽  
Host Interactions ◽  
Disease States ◽  
Group A ◽  
Specific Tissue

The ability of bacteria to cause immunopathological damage in the host may take a variety of forms. These pathways may be conveniently grouped under three major headings: (1) organisms that can cause damage via shared antigenic determinants between host and bacterium; (2) those organisms that suppress the host’s response; and (3) organisms that release substances with specific biological properties or have receptors for specific tissue sites. The group A streptococcus is among the most versatile of these bacteria because it appears that it may use all three pathways in various streptococcal-related disease states. In rheumatic fever and chorea it appears that cross-reactive antigens play a major role in inducing immunopathological damage in that there is both a heightened humoral and cellular reaction by the host to these cross-reactive determinants. Recent evidence also indicates that rheumatic fever individuals express certain B cell antigens that may be associated with susceptibility to the disease. In the other complications of streptococcal infections, namely poststreptococcal glomerulonephritis, the bacterium uses both suppression of the host’s immune response and the excretion of a particular protein common to all nephritis-associated strains to achieve its immunopathological damage. In this context, other examples of bacterial-host interactions will be discussed as evidence for the common pathways used by microbes to cause immunopathological damage in the host.

Rheumatic Fever Article Questioned

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1133-1134
Author(s):  
SYLVIA P. GRIFFITHS
Keyword(s):  
Rheumatic Fever ◽  
Intramuscular Injection ◽  
Group A Streptococcus ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
Group A

To the Editor.— The suggestion of Nordin1 that there may be a need to re-evaluate the current recommended prophylaxis for children with rheumatic fever is valid, particularly if carefully planned and controlled studies could be carried out. However, the author's contention that "It has been assumed that the levels of penicillin [following monthly intramuscular injection of 1.2 million units of benzathine penicillin G] are adequate to prevent reinfection with group A streptococcus, and hence to prevent recurrences of rheumatic fever" has always been qualified by others.

Acute Rheumatic Fever After Group A Streptococcus Pyoderma and Group G Streptococcus Pharyngitis

2017 ◽  
Vol 36 (7) ◽  
pp. 692-694 ◽  
Author(s):  
Lance O’Sullivan ◽  
Nicole J. Moreland ◽  
Rachel H. Webb ◽  
Arlo Upton ◽  
Nigel J. Wilson
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Group A Streptococcus ◽  
Group A

scholarly journals Characterization of Two Novel Pyrogenic Toxin Superantigens Made by an Acute Rheumatic Fever Clone of Streptococcus pyogenes Associated with Multiple Disease Outbreaks

2002 ◽  
Vol 70 (12) ◽  
pp. 7095-7104 ◽  
Author(s):  
Laura M. Smoot ◽  
John K. McCormick ◽  
James C. Smoot ◽  
Nancy P. Hoe ◽  
Ian Strickland ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Mononuclear Cells ◽  
Group A Streptococcus ◽  
Human Peripheral Blood ◽  
Disease Outbreaks ◽  
Peripheral Blood Mononuclear ◽  
Human T Cells ◽  
Group A

ABSTRACT The pathogenesis of acute rheumatic fever (ARF) is poorly understood. We identified two contiguous bacteriophage genes, designated speL and speM, encoding novel inferred superantigens in the genome sequence of an ARF strain of serotype M18 group A streptococcus (GAS). speL and speM were located at the same genomic site in 33 serotype M18 isolates, and no nucleotide sequence diversity was observed in the 33 strains analyzed. Furthermore, the genes were absent in 13 non-M18 strains tested. These data indicate a recent acquisition event by a distinct clone of serotype M18 GAS. speL and speM were transcribed in vitro and upregulated in the exponential phase of growth. Purified SpeL and SpeM were pyrogenic and mitogenic for rabbit splenocytes and human peripheral blood mononuclear cells in picogram amounts. SpeL preferentially expanded human T cells expressing T-cell receptors Vβ1, Vβ5.1, and Vβ23, and SpeM had specificity for Vβ1 and Vβ23 subsets, indicating that both proteins had superantigen activity. SpeL was lethal in two animal models of streptococcal toxic shock, and SpeM was lethal in one model. Serologic studies indicated that ARF patients were exposed to serotype M18 GAS, SpeL, and SpeM. The data demonstrate that SpeL and SpeM are pyrogenic toxin superantigens and suggest that they may participate in the host-pathogen interactions in some ARF patients.

scholarly journals Delayed Diagnosis of Acute Rheumatic Fever in a Patient with Multiple Emergency Department Visits

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Inna Kaminecki ◽  
Renuka Verma ◽  
Jacqueline Brunetto ◽  
Loyda I. Rivera
Keyword(s):  
Emergency Department ◽  
Rheumatic Fever ◽  
Health Care Providers ◽  
Acute Rheumatic Fever ◽  
Group A Streptococcus ◽  
The United States ◽  
Emergency Department Visits ◽  
Penicillin G ◽  
Care Providers ◽  
Group A

While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss followinggroup A Streptococcuspharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment ofgroup A Streptococcuspharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow-up with a cardiologist every 1-2 years is essential to assess the heart for valve damage.

scholarly journals Rheumatic Heart Disease and Its Association with H. pylori Infection

2021 ◽  
Author(s):  
Ghadeer Turki Aloutaibi ◽  
Abdulrahman L. Al-Malki ◽  
Maha J. Balgoon ◽  
Saud A. Bahaidarah ◽  
Said Salama Moselhy
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Group A Streptococcus ◽  
Clinical Manifestations ◽  
Group A ◽  
H Pylori ◽  
Rheumatic Heart

Acute rheumatic fever (ARF) triggered by Group A streptococcus bacterium due to post-infectious and non-supportive pharyngeal infection. Depending on certain conditions, such as genetic predisposition to the disease, the prevalence of various cases of rheumatism and socioeconomic status in different regions, ARF can have different clinical manifestations. The disease typically manifested by one or more acute episodes, whereas 30-50% of all repeated ARF status can result in chronic rheumatic heart disease (RHD) with gradual and irreversible heart valve damage and also have been found to be correlated with a raised risk of myocardial infarction (MI), cardiovascular disease (CVD) and dyslipidemia. The RHD is the only long-term consequence of ARF and the most serious. The development to chronic RHD is determined by many factors, most notably the frequent episodes of rheumatic fever (RF). The RHD is known socially and economically as being the most frequent heart disease in vulnerable populations. H.pylori infection has been proposed to be involved RHD greater than that of the normal healthy people. H.pylori can be considered as one of the probable risk factor for RHD.It was concluded that patients with H. Pylori should be advised to follow up in cardiology clinics to avoid any complications.

scholarly journals Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever: evidence from New Zealand

2021 ◽  
Vol 6 (12) ◽  
pp. e007038
Author(s):  
Jane Oliver ◽  
Julie Bennett ◽  
Sally Thomas ◽  
Jane Zhang ◽  
Nevil Pierse ◽  
...  
Keyword(s):  
New Zealand ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Throat Swab ◽  
Group A Streptococcus ◽  
Population Level ◽  
Gas Detection ◽  
Positive Skin ◽  
Group A ◽  
Dispensing Data

IntroductionAcute rheumatic fever (ARF) is usually considered a consequence of group A streptococcus (GAS) pharyngitis, with GAS skin infections not considered a major trigger. The aim was to quantify the risk of ARF following a GAS-positive skin or throat swab.MethodsThis retrospective analysis used pre-existing administrative data. Throat and skin swab data (1 866 981 swabs) from the Auckland region, New Zealand and antibiotic dispensing data were used (2010–2017). Incident ARF cases were identified using hospitalisation data (2010–2018). The risk ratio (RR) of ARF following swab collection was estimated across selected features and timeframes. Antibiotic dispensing data were linked to investigate whether this altered ARF risk following GAS detection.ResultsARF risk increased following GAS detection in a throat or skin swab. Māori and Pacific Peoples had the highest ARF risk 8–90 days following a GAS-positive throat or skin swab, compared with a GAS-negative swab. During this period, the RR for Māori and Pacific Peoples following a GAS-positive throat swab was 4.8 (95% CI 3.6 to 6.4) and following a GAS-positive skin swab, the RR was 5.1 (95% CI 1.8 to 15.0). Antibiotic dispensing was not associated with a reduction in ARF risk following GAS detection in a throat swab (antibiotics not dispensed (RR: 4.1, 95% CI 2.7 to 6.2), antibiotics dispensed (RR: 4.3, 95% CI 2.5 to 7.4) or in a skin swab (antibiotics not dispensed (RR: 3.5, 95% CI 0.9 to 13.9), antibiotics dispensed (RR: 2.0, 95% CI 0.3 to 12.1).ConclusionsA GAS-positive throat or skin swab is strongly associated with subsequent ARF, particularly for Māori and Pacific Peoples. This study provides the first population-level evidence that GAS skin infection can trigger ARF.

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