Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series

2021 ◽  
pp. 1-13
Author(s):  
Daniel A. Kinderlehrer ◽  
Nancy Brown
Keyword(s):  
Mental Illness ◽  
Residential Treatment ◽  
Group A Streptococcus ◽  
Case Series ◽  
Treatment Center ◽  
Antineuronal Antibodies ◽  
Psychiatric Disturbances ◽  
Psychological Dysfunction ◽  
Group A ◽  
Intensive Residential Treatment

The incidence of mental health disorders in adolescents continues to rise. The cause of the increase in mental illness is multifactorial, including both environmental and biological causes. To investigate the latter, ten adolescents at a psychiatric residential treatment center in Colorado with the DSM-5 diagnosis of major depressive disorder (MDD), of whom seven were additionally diagnosed with generalized anxiety disorder (GAD), were chosen at random for further serologic study. Testing revealed exposureto group A Streptococcus(GAS) in 2 of 10 (20%); Borrelia Burgdorferi sensulato (Bbsl)in 2 of 10 (20%); and Bartonella speciesin 3 of 10 (30%). In addition, 9 of 10 (90%) subjects had abnormal Cunningham Panels, which measures levels of antineuronal antibodies that have been associated with psychiatric disturbances. Given the degree of psychological dysfunction in these adolescents requiring intensive residential treatment, this case series lends support to the hypothesis that exposure to infectious agents may play a role, perhaps by autoimmune mechanisms, in the significant and ongoing rise in the rate of neuropsychiatric illness in adolescents. This preliminary report adds to this premise and requires further investigation.

scholarly journals Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Beta-Haemolytic Streptococcal Infection: An Indication for Tonsillectomy? A Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Amarkumar Dhirajlal Rajgor ◽  
Navid Akhtar Hakim ◽  
Sanah Ali ◽  
Adnan Darr
Keyword(s):  
Streptococcal Infection ◽  
Group A Streptococcus ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Acute Onset ◽  
Neuropsychiatric Disorder ◽  
Inclusion Criteria ◽  
Definitive Evidence ◽  
Group A

Background. Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS) is the acute onset of neuropsychiatric symptoms following group A beta-haemolytic streptococcal infection. The aetiology remains elusive. However, with group A streptococcus being the most common bacterial cause of tonsillitis, surgical intervention in the form of tonsillectomy has often been considered as a potential therapy. Methods. A MEDLINE® search was undertaken using keywords “PANDAS” or “paediatric autoimmune neuropsychiatric disorders associated with streptococcus” combined with “tonsillectomy”. Results. Six case reports and 3 case series met the inclusion criteria. Demesh et al. (case series) reported a dramatic reduction in neuropsychiatric symptom severity in the patient cohort undergoing tonsillectomy. Two case series suggest that there is no association between tonsillectomy and resolution of PANDAS. Conclusion. Due to the lack of uniform data and sporadic reports, tonsillectomy should be carefully adopted for the treatment of this disorder. In particular, tonsillectomies/adenoidectomies to alleviate neuropsychiatric symptoms should be avoided until more definitive evidence is at our disposal. This review highlights the importance of a potential collaborative prospective study.

When Love is Not Enough: Parenting an Adopted Child with Mental Illness

2017 ◽  
Vol 98 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Michele D. Hanna ◽  
Erin Boyce ◽  
Diane Mulligan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Child Welfare ◽  
Residential Treatment ◽  
The United States ◽  
Adoptive Parents ◽  
Treatment Center ◽  
Adopted Children ◽  
Adopted Child ◽  
Adoptive Families

This article presents the results of a qualitative study designed to explore the experiences of adoptive parents who placed an adopted child with mental illness in a residential treatment center (RTC). Twenty-four adoptive families from across the United States who placed an adopted child in residential treatment were interviewed. The adopted children represented various types of adoption including public child welfare, domestic infant, and intercountry adoption. Parents reported feeling victimized by their child and by the very systems designed to help them, including child welfare, mental health, health care, and education. The findings reveal signs of trauma in the adoptive parents as a result of their experiences. The article concludes with recommendations from adoptive parents for adoption, mental health, and residential treatment professionals who work with adopted children and their families.

Reducing Psychotropic Medications in an Intensive Residential Treatment Center

2012 ◽  
Vol 23 (4) ◽  
pp. 675-685 ◽  
Author(s):  
Jonathan C. Huefner ◽  
Annette K. Griffith ◽  
Gail L. Smith ◽  
Dennis G. Vollmer ◽  
Laurel K. Leslie
Keyword(s):  
Residential Treatment ◽  
Psychotropic Medications ◽  
Treatment Center ◽  
Residential Treatment Center ◽  
Intensive Residential Treatment

scholarly journals Opsonophagocytosis-Inhibiting Mac Protein of Group A Streptococcus: Identification and Characteristics of Two Genetic Complexes

2002 ◽  
Vol 70 (12) ◽  
pp. 6880-6890 ◽  
Author(s):  
Benfang Lei ◽  
Frank R. DeLeo ◽  
Sean D. Reid ◽  
Jovanka M. Voyich ◽  
Loranne Magoun ◽  
...  
Keyword(s):  
Complex I ◽  
Group A Streptococcus ◽  
Allelic Variation ◽  
Case Series ◽  
M Protein ◽  
Complex Ii ◽  
Rgd Motif ◽  
Apparent Homogeneity ◽  
Endopeptidase Activity ◽  
Group A

ABSTRACT Recently, it was reported that a streptococcal Mac protein (designated Mac5005) made by serotype M1 group A Streptococcus (GAS) is a homologue of human CD11b that inhibits opsonophagocytosis and killing of GAS by human polymorphonuclear leukocytes (PMNs) (B. Lei, F. R. DeLeo, N. P. Hoe, M. R. Graham, S. M. Mackie, R. L. Cole, M. Liu, H. R. Hill, D. E. Low, M. J. Federle, J. R. Scott, and J. M. Musser, Nat. Med. 7:1298-1305, 2001). To study mac variation and expression of the Mac protein, the gene in 67 GAS strains representing 36 distinct M protein serotypes was sequenced. Two distinct genetic complexes were identified, and they were designated complex I and complex II. Mac variants in each of the two complexes were closely related, but complex I and complex II variants differed on average at 50.66 ± 5.8 amino acid residues, most of which were located in the middle one-third of the protein. Complex I Mac variants have greater homology with CD11b than complex II variants. GAS strains belonging to serotypes M1 and M3, the most abundant M protein serotypes responsible for human infections in many case series, have complex I Mac variants. The mac gene was cloned from representative strains assigned to complexes I and II, and the Mac proteins were purified to apparent homogeneity. Both Mac variants had immunoglobulin G (IgG)-endopeptidase activity. In contrast to Mac5005 (complex I), Mac8345 (complex II) underwent autooxidation of its cysteine residues, resulting in the loss of IgG-endopeptidase activity. A Mac5005 Cys94Ala site-specific mutant protein was unable to cleave IgG but retained the ability to inhibit IgG-mediated phagocytosis by human PMNs. Thus, the IgG-endopeptidase activity was not essential for the key biological function of Mac5005. Although Mac5005 and Mac8345 each have an Arg-Gly-Asp (RGD) motif, the proteins differed in their interactions with human integrins αvβ3 and αIIbβ3. Binding of Mac5005 to integrins αvβ3 and αIIbβ3 was mediated primarily by the RGD motif in Mac5005, whereas binding of Mac8345 involved the RGD motif and a region in the middle one-third of the molecule whose sequence is different in Mac8345 and Mac5005. Taken together, the data add to the emerging theme in GAS pathogenesis that allelic variation in virulence genes contributes to fundamental differences in host-pathogen interactions among strains.

scholarly journals A five-year review of necrotising fasciitis in a tertiary referral unit

2013 ◽  
Vol 95 (1) ◽  
pp. 57-60 ◽  
Author(s):  
RA Swain ◽  
JC Hatcher ◽  
BS Azadian ◽  
N Soni ◽  
B De Souza
Keyword(s):  
Scoring System ◽  
Group A Streptococcus ◽  
Case Series ◽  
Necrotising Fasciitis ◽  
Risk Indicator ◽  
Tertiary Referral ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Group A ◽  
Spread Of Infection

Introduction Necrotising fasciitis is a life-threatening illness that is often difficult to diagnose. Immediate debridement and intravenous antibiotic therapy are required to limit the spread of infection. This five-year audit aimed to review the number and outcomes of all cases of necrotising fasciitis admitted to a tertiary referral unit and to assess the validity of the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scoring system. Methods A retrospective analysis of patient notes over the five-year period from October 2006 to October 2011 was undertaken. The LRINEC score was calculated for each patient to evaluate its usefulness. Results Overall, 15 patients were diagnosed with necrotising fasciitis. Three patients died. The median age of patients was 51.0 years (range: 34–76 years). There were no obvious predisposing factors in 8 cases but patients had a median of 2.0 co-morbidities. The most common infective agent, present in five patients, was Group A Streptococcus. Other monomicrobial agents included Group G Streptococcus and Klebsiella pneumoniae. Polymicrobial infections were less common than monomicrobial infections and two patients had a polymicrobial infection including methicillin-resistant Staphylococcus aureus. Although the LRINEC scoring system identified 12 of the 15 patients as having a high or intermediate likelihood of necrotising fasciitis, 3 were classified as low likelihood. Conclusions This limited case series strongly suggests that the LRINEC system is too insensitive for diagnosis.

scholarly journals Postpartum Group A Streptococcus Case Series: Reach Out to Infection Prevention!

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Andrew J Alexander ◽  
Carol Myers ◽  
Stephen B Beres ◽  
Randall J Olsen ◽  
James M Musser ◽  
...  
Keyword(s):  
Health Care ◽  
Streptococcus Pyogenes ◽  
Infection Prevention ◽  
Group A Streptococcus ◽  
Case Series ◽  
Hospital Staff ◽  
Whole Genome ◽  
Group A ◽  
Care Worker ◽  
Rule Out

Abstract A series of postpartum Streptococcus pyogenes infections prompted an investigation to rule out potential transmission by a health care worker. None of the hospital staff screened were colonized. All isolates were determined to be unrelated by molecular methods, including whole-genome sequencing. Thus, nosocomial transmission was considered unlikely.

Etiology, clinical presentation, laboratory diagnostics, pathogenesis of impetigo and treatment methods

2020 ◽  
pp. 64-70
Author(s):  
Anastasiya Laknitskaya
Keyword(s):  
Streptococcus Pyogenes ◽  
Skin Diseases ◽  
Group A Streptococcus ◽  
Antibiotic Sensitivity ◽  
Antioxidant Defense System ◽  
Laboratory Diagnostics ◽  
Treatment Methods ◽  
Group A ◽  
The Individual

Currently, one of the priority medical and social problems is the optimization of treatment methods for pyoderma associated with Streptococcus pyogenes — group A streptococcus (GAS). To date, the proportion of pyoderma, the etiological factor of which is Streptococcus pyogenes, is about 6 % of all skin diseases and is in the range from 17.9 to 43.9 % of all dermatoses. Role of the bacterial factor in the development of streptococcal pyoderma is obvious. Traditional treatment complex includes antibacterial drugs selected individually, taking into account the antibiotic sensitivity of pathognomonic bacteria, and it is not always effective. Currently implemented immunocorrection methods often do not take into account specific immunological features of the disease, the individual, and the fact that the skin performs the function of not only a mechanical barrier, but it is also an immunocompetent organ. Such an approach makes it necessary to conduct additional studies clarifying the role of factors of innate and adaptive immunity, intercellular mediators and antioxidant defense system, that allow to optimize the treatment of this pathology.

Sign in / Sign up

Export Citation Format

Share Document