Modern understanding about the role of group A β -hemolytic streptococcus in acute tonsillitis

Objective: assess the modern value of group А β-hemolytic streptococcus in patients with acute tonsillitis and the effectiveness of the rapid streptococcal antigen detection method.Materials and methods: microbial landscape assessment of acute tonsillitis was based on retrospective analysis of 902 bacterial culture results of a throat swab of patients with syndromes of acute tonsillitis treated in the Infectious Diseases Clinic of the Military Medical Academy named after S.M. Kirov during the period of 2019-2020. The effectiveness of the rapid streptococcal antigen detection method in the oropharynx was determined by a prospective study involving 35 patients with acute tonsillitis.Results: in the study, we have found that bacterial culture results of a throat swab, the following were more common: Nesseria species (39 %), Streptococcus viridans (23 %), and Staphylococcus aureus (17 %). The frequency of detection of β-hemolytic streptococcus was 1 %. The rapid diagnostic system «Streptatest» in patients with acute tonsillitis has demonstrated efficiency, under which that sensitivity of test was 80 %, specificity – 90 %, positive predictive value – 57,14 %, negative predictive value – 96,43 %.Conclusions: the frequency of group A β-hemolytic streptococcus in patients with lesion of lymphoid tissues of the oropharynx has declined significantly nowadays. The rapid diagnostic system «Streptatest» is a highly effective medical product that can be used in both hospital and pre-hospital stage.

The Multifaceted Nature of Streptococcal Antigen I/II Proteins in Colonization and Disease Pathogenesis

Streptococci are Gram-positive bacteria that belong to the natural microbiota of humans and animals. Certain streptococcal species are known as opportunistic pathogens with the potential to cause severe invasive disease. Antigen I/II (AgI/II) family proteins are sortase anchored cell surface adhesins that are nearly ubiquitous across streptococci and contribute to many streptococcal diseases, including dental caries, respiratory tract infections, and meningitis. They appear to be multifunctional adhesins with affinities to various host substrata, acting to mediate attachment to host surfaces and stimulate immune responses from the colonized host. Here we will review the literature including recent work that has demonstrated the multifaceted nature of AgI/II family proteins, focusing on their overlapping and distinct functions and their important contribution to streptococcal colonization and disease.

Immunopathogenesis of Behçet Disease

Background: Behçet’s Disease (BD, OMIM 109650) is a chronic relapsing inflammatory disease of unknown etiology with unpredictable exacerbations and remissions. First described in 1937 by the Turkish dermatologist HulusiBehçet, as a trisympton complex (oral and genital ulcers and uveitis), it is now recognized as a multisystemic disease. The syndrome can manifest in diverse ways and can involve nearly every organ system. Several studies have implicated T cells and monocytes in the pathogenesis of BD especially when these cells are stimulated by heat shock proteins and streptococcal antigen. This article presents a review of the relevant published literature about the immunopathogenesis of BD. Result: The authors used MeSH terms “Behçet’s disease” with “pathophysiology,” “pathogenesis,” “genetic”, “epigenetic”, “immunogenetic” or “immune response” to search the PubMed database. All the relevant studies identified were included.

Junctional tachycardia in a child with non-rheumatic fever streptococcal pharyngitis

Accelerated junctional rhythm has been reported in children in the setting of acute rheumatic fever; however, we describe a hitherto unreported case of isolated junctional tachycardia in a child with streptococcal pharyngitis, not meeting revised Jones criteria for rheumatic fever. A previously healthy, 9-year-old girl presented to the emergency department with complaints of sore throat, low-grade fever, and intermittent chest pain. She was found to have a positive rapid streptococcal antigen test. The initial electrocardiogram showed junctional tachycardia with atrioventricular dissociation in addition to prolonged and aberrant atrioventricular conduction. An echocardiogram revealed normal cardiac anatomy with normal biventricular function. The patient responded to treatment with amoxicillin for streptococcal pharyngitis. The junctional tachycardia and other electrocardiogram abnormalities resolved during follow-up.