An unusual presentation of group A streptococcus infection in a newborn: with acute mastoiditis with no obvious clinical manifestation

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Peymaneh Alizadeh Taheri ◽  
Mohsen Jafari ◽  
Fouzieh Mehrazmai
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Clinical Manifestation ◽  
Group A Streptococcus ◽  
Term Neonate ◽  
Unusual Presentation ◽  
Acute Mastoiditis ◽  
Group A ◽  
Temporal Bones ◽  
Streptococcus A

Abstract Acute mastoiditis (AM) is rarely seen in newborns. It is characterized by retroauricular pain, swelling, tenderness and protrusion of the auricle. This is the first report of the neonatal mastoiditis in a 17-day-old term neonate with no obvious clinical manifestation of mastoiditis and no associated malformation of the ears and mastoids. A computed tomography (CT) scan of the temporal bones revealed right mastoiditis without osteitis, destruction of the mastoid bone or abscess formation. Discharge culture revealed streptococcus A colonies sensitive to ampicillin, ceftriaxone, vancomycin and chloramphenicol. She was successfully treated with intravenous ampicillin and ceftizoxime. No complication or recurrence was reported.

scholarly journals The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

2019 ◽  
Vol 25 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Hiroaki Tanaka ◽  
Shinji Katsuragi ◽  
Junichi Hasegawa ◽  
Kayo Tanaka ◽  
Kazuhiro Osato ◽  
...  
Keyword(s):  
Group A Streptococcus ◽  
Nationwide Survey ◽  
Group A ◽  
Maternal Sepsis ◽  
Streptococcus A

scholarly journals Biofilm formation by group A Streptococcus: a role for the streptococcal regulator of virulence (Srv) and streptococcal cysteine protease (SpeB)

Microbiology ◽  
2009 ◽  
Vol 155 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Christopher D. Doern ◽  
Amity L. Roberts ◽  
Wenzhou Hong ◽  
Jessica Nelson ◽  
Slawomir Lukomski ◽  
...  
Keyword(s):  
Cysteine Protease ◽  
Biofilm Formation ◽  
Group A Streptococcus ◽  
Immunoblot Analysis ◽  
Wild Type ◽  
Flow Conditions ◽  
Group A ◽  
Streptococcus A ◽  
Insight Into ◽  
Western Immunoblot Analysis

Recently, biofilms have become a topic of interest in the study of the human pathogen group A Streptococcus (GAS). In this study, we sought to learn more about the make-up of these structures and gain insight into biofilm regulation. Enzymic studies indicated that biofilm formation by GAS strain MGAS5005 required an extracellular protein and DNA component(s). Previous results indicated that inactivation of the transcriptional regulator Srv in MGAS5005 resulted in a significant decrease in virulence. Here, inactivation of Srv also resulted in a significant decrease in biofilm formation under both static and flow conditions. Given that production of the extracellular cysteine protease SpeB is increased in the srv mutant, we tested the hypothesis that increased levels of active SpeB may be responsible for the reduction in biofilm formation. Western immunoblot analysis indicated that SpeB was absent from MGAS5005 biofilms. Complementation of MGAS5005Δsrv restored the biofilm phenotype and eliminated the overproduction of active SpeB. Inhibition of SpeB with E64 also restored the MGAS5005Δsrv biofilm to wild-type levels.

scholarly journals 1132. Evaluation of Broad-Spectrum Antimicrobial Therapy for Acute Mastoiditis in Pediatric Patients: An Antimicrobial Stewardship Perspective

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S402-S403
Author(s):  
Soyoon Kim ◽  
Brady Moffett ◽  
Beth Pali ◽  
Jill D’Souza ◽  
Ankhi Dutta
Keyword(s):  
Pediatric Patients ◽  
Surgical Intervention ◽  
Clinical Laboratory ◽  
Group A Streptococcus ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Intracranial Extension ◽  
Acute Mastoiditis ◽  
Antimicrobial Management ◽  
Group A

Abstract Background Acute mastoiditis (AM) continues to remain a serious complication of acute otitis media in children. There is a significant variation in antimicrobial management in children with AM. Recent studies and UptoDate recommends empiric coverage with vancomycin and antipseudomonal medication in patients with AM. The purpose of this study was to evaluate the epidemiology, management and outcome of AM in pediatric patients. Methods A retrospective, observational study was designed evaluating epidemiology and management of AM in hospitalized pediatric patients from July 1, 2011 to June 30, 2017. Patients between 6 months and 19 years of age admitted with a diagnosis of AM as per ICD 9/10 coded were included in the study. Information regarding demographic, clinical, laboratory, microbiological, radiological, antibiotic (Abx) usage, surgical intervention and outcome were collected from medical records. Results A total of 97 patients were evaluated (64% male, mean age 6.6 ± 4.3 years). Cultures (Cx) were obtained in 95 patients as in Figure 1. Of the patients who grew P.aeroginosa, 2 had intracranial extension, both of which were polymicrobial and 5 did not receive empiric antipseudomonal therapy but had no complications on follow-up. Table 1 shows the most common empiric Abx therapy. Fifty-nine patients (61.5%) had a change in Abx, the most common being a ceftriaxone or a combination of clindamycin and ceftriaxone. Except for those with complicated AM, none required definitive vancomycin therapy. Thirty-two patients (33%) had a complicated mastoiditis with epidural abscess, thrombosis, and/or intracranial extension. Eighty-six patients (86.8%) required surgical intervention. Mastoidectomy was performed in 34% while others had myringotomy and tympanostomy tube placement and/or drainage of subperiosteal abscesses without subsequent complications. Conclusion Group A Streptococcus, Streptococcus pneumoniae and Pseudomonas were the predominant pathogens in acute AM in children. Vancomycin and empiric antipseudomonal coverage may not be needed in patients with uncomplicated AM. Broader spectrum Abx with intracranial penetration should be reserved for those with complicated AM. Disclosures All authors: No reported disclosures.

scholarly journals Oral cavity swabbing for diagnosis of group a Streptococcus: a prospective study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Limor Adler ◽  
Miriam Parizade ◽  
Gideon Koren ◽  
Ilan Yehoshua
Keyword(s):  
Oral Cavity ◽  
Prospective Study ◽  
Group A Streptococcus ◽  
Group A ◽  
A Prospective Study ◽  
Streptococcus A

scholarly journals Tonsillopharyngitis Caused by Foodborne Group A Streptococcus: A Prison‐Based Outbreak

2003 ◽  
Vol 36 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Michael Levy ◽  
Christine G. Johnson ◽  
Ed Kraa
Keyword(s):  
Group A Streptococcus ◽  
Group A ◽  
Streptococcus A

scholarly journals Perianal streptococcal disease in childhood: systematic literature review

2021 ◽  
Author(s):  
Renato Gualtieri ◽  
Gabriel Bronz ◽  
Mario G. Bianchetti ◽  
Sebastiano A. G. Lava ◽  
Elena Giuliano ◽  
...  
Keyword(s):  
Rectal Bleeding ◽  
Predictive Value ◽  
Group A Streptococcus ◽  
National Library ◽  
Asymptomatic Group ◽  
Time To Diagnosis ◽  
Long Time ◽  
Group A ◽  
Defecation Disorders ◽  
Streptococcus A

AbstractGroup A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness. Perianitis is associated with a streptococcal tonsillopharyngitis in about every fifth case. The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases. An asymptomatic group A streptococcal throat carriage occurs in 63% of cases. As compared with perianal Streptococcus A culture, the rapid streptococcal tests have a positive predictive value of 80% and a negative predictive value of 96%. It is hypothesized that digital inoculation from nasopharynx to anus underlies perianitis. Many cases are likely caused directly by children, who are throat and nasal carriers of Streptococcus A. Some cases might occur in children, who have their bottoms wiped by caregivers with streptococcal tonsillopharyngitis or carriage of Streptococcus.Conclusion: Perianitis is an infection with a distinctive presentation and a rather long time to diagnosis. There is a need for a wider awareness of this condition among healthcare professionals. What is Known:• Group A Streptococcus may cause perianitis in childhood.• Systemic antimicrobials (penicillin V, amoxycillin, or cefuroxime) are superior to topical treatment. What is New:• The clinical presentation is distinctive (defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness).• The time to diagnosis is usually ≥3 weeks.Recurrences occur in about 20% of cases.

scholarly journals Accuracy of Alvarado Scoring System and Selective Computed Tomography in Diagnosis of Suspected Cases of Acute Appendicitis

2020 ◽  
Vol 1 (2) ◽  
pp. 01-11
Author(s):  
Abbas AR Mohamed ◽  
Safaa A Mobarki ◽  
Ashwag H Al Qabasani ◽  
Nusiba A Al Shingiti ◽  
Alaa A El Sayed
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Scoring System ◽  
Oral Contrast ◽  
Middle Group ◽  
Group A ◽  
Group B

Objective: To evaluate the diagnostic accuracy of combined Alvarado scoring system and selective computed tomography (CT) in the diagnosis of suspected cases of acute appendicitis. Material and methods: This study was conducted during the period March 2018 to January 2020 at Prince Mohammed bin Abdul-Aziz hospital (NGHA) in Al Madinah, KSA. It is a prospective study involving 100 consecutive patients attending the emergency department with right iliac fossa pain, excluding children below the age of 14 years and pregnant women. All patients were initially assessed by the Alvarado scoring system, and the result of each patient was recorded in a separate predesigned data sheath. Based on the patient's calculated Alvarado scores, patients were stratified into three groups: Group A (score ≤ 4), Group B (score 5-6), and group C (score ≥ 7). All patients in group A were discharged from the emergency department with instruction to return if their symptoms persist or get worse while all patients in group B had an abdominal multidetector CT scan (MDCT) with IV contrast and no oral contrast to help the diagnosis. Group C patients had surgery without further investigation. Alvarado scores were compared to intraoperative findings and histopathological examination of the removed appendix in those who were operated. The sensitivity, specificity, positive and negative predictive values of the scoring system in each group were calculated with special reference to the role of CT scan in improving the diagnostic accuracy of the scoring system in the middle group (group B). Result: 58 patients were male and 42 were female. Age range between 14 and 43 years with median age 24 years. Out of the 100 patients, 14 (8 males, 6 females) belonged to Group A, 23 (11 males, 12 females) to Group B and 63 (39 males, 24 females) to group C. Two patients from group A (one male and one female) were returned with worsening symptoms and subsequently operated for acute appendicitis. CT scan established the diagnosis of acute appendicitis in 16 out of the patients of group B with subsequent histological confirmation of acute appendicitis in 15 of them. Histopathology confirmed the diagnosis of acute appendicitis in 32 out of 63 patients of group C. Conclusion: Alvarado score has a high accuracy of ruling in and out acute appendicitis at the extremes of the score (≤7 and ≥4), however, the accuracy of the score to confirm or rule out acute appendicitis in the middle group (5 -6) is significantly low. Selective utilization of CT scan in patients in the middle of the score improves the diagnostic accuracy of the score and limits overutilization of CT scan in the other patients at the extremes of the score saving patients unnecessary exposure to radiation and health authorities’ time and cost without increasing the rate of negative appendectomy.

scholarly journals Superior Canal Dehiscence: A Comparative Postmortem Multislice Computed Tomography Study

OTO Open ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 2473974X1879357 ◽  
Author(s):  
Philipp Mittmann ◽  
Arne Ernst ◽  
Rainer Seidl ◽  
Anna-Felicitas Skulj ◽  
Sven Mutze ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Ct Scan ◽  
Temporal Bone ◽  
Multislice Ct ◽  
Ct Imaging ◽  
Autopsy Findings ◽  
Superior Canal Dehiscence ◽  
Temporal Bones ◽  
Canal Dehiscence

Objective Superior canal dehiscence is defined by missing bony coverage of the superior canal against the middle cranial fossa. The gold standard in diagnosis is high-resolution computed tomography (CT). A false-positive CT scan, identifying a dehiscence when one is not present, could lead to unnecessary surgical therapy. This study aims to compare postmortem CT scans with autopsy findings with regard to superior canal dehiscence. Study Design Postmortem study. Setting Tertiary referral center. Subjects and Methods Twenty-two nontraumatic death cases within a 3-month period (January to March 2017) were included with 44 temporal bones. Each body underwent postmortem head CT prior to medicolegal autopsy. The middle fossa floor was exposed, and if present, the superior semicircular canal dehiscence was identified and measured. In each case, 3 comparable photographs were taken during the autopsy (left temporal bone, right temporal bone, overview). Results Autopsy findings revealed bony dehiscences in 11% of the temporal bones, whereas CT scan revealed bony dehiscences in 16%. The length of the dehiscences were longer when measured by CT imaging. Conclusion The diagnosis of superior canal dehiscence syndrome requires high-resolution CT with clinical symptoms and physiologic evidence of a third mobile window. Our study underlines a mismatch between multislice CT imaging in the coronal plane and the presence of a dehiscence on autopsy.

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