Hemolytic Streptococcus - Causes, Symptoms And Treatment Of Streptococcus In The Throat, In A Smear

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment of streptococcus

Streptococcus is one of those pathogenic microbes that are normally found in the microflora of any person. The bacterium stays on the mucous membrane of the nose and throat, in the respiratory tract, large intestine and urogenital organs, and for the time being does not cause any harm to its host. Streptococcal infections occur only in conditions of weakened immunity, hypothermia, or a large amount of an unknown strain of pathogens entering the body at once.

Not all varieties of streptococci are dangerous to human health, moreover, there are even microbes in this group that are beneficial. The very fact of carrying a bacterium should not become a cause for alarm, because it is almost impossible to avoid it, just as it is impossible to completely eradicate streptococcus from your body. And strong immunity and adherence to basic rules of personal hygiene give every reason to expect that the disease will bypass you.

Nevertheless, everyone is concerned about the question of what to do if you or your loved ones are still sick: what medications to take, and what complications to worry about. Today we will tell you absolutely everything about streptococcus and the diseases that it causes, as well as methods for diagnosing and treating streptococcal infections.

Content:

• What is streptococcus?
• Causes of streptococcal infections
• Streptococcus groups
• Streptococcus in adults
• Streptococcus in children
• Streptococcus in pregnant women
• Complications and consequences of streptococcus
• Diagnosis of streptococcus
• Answers to important questions about streptococcus
• Streptococcus treatment

What is streptococcus?

From a scientific point of view, streptococcus is a member of the Streptococcaceae family, a globular or ovoid asporogenic Gram-positive facultative anaerobic bacterium. Let's understand these complex terms and "translate" them into simple human language: streptococci have the shape of a regular or slightly elongated ball, do not form a spore, do not have flagella, cannot move, but they can live in a complete absence of oxygen.

If you look at streptococci through a microscope, you can see that they never occur singly - only in pairs or in the form of regular chains. In nature, these bacteria are very widespread: they are found in the soil, and on the surface of plants, and on the body of animals and humans. Streptococci are very resistant to heat and freezing, and even when lying in roadside dust, they retain the ability to reproduce for years. However, they can be easily defeated with penicillin antibiotics, macrolides or sulfonamides.

In order for a streptococcal colony to begin to develop actively, it needs a nutrient medium in the form of serum, sweet solution or blood. In laboratories, bacteria are artificially created favorable conditions in order to observe how they multiply, ferment carbohydrates, and release acid and toxins. A colony of streptococci forms a translucent or greenish film on the surface of a liquid or solid nutrient material. Studies of its chemical composition and properties allowed scientists to determine the pathogenicity factors of streptococcus and establish the causes of the development of streptococcal infections in humans.

Causes of streptococcal infections

Almost all streptococcal infections are caused by beta-hemolytic streptococcus, since it is he who is able to destroy red blood cells - erythrocytes. In the process of vital activity, streptococci release a number of toxins and poisons that have a detrimental effect on the human body. This explains the unpleasant symptoms of diseases caused by streptococcus: pain, fever, weakness, nausea.

The pathogenicity factors of streptococcus are as follows:

• Streptolysin is the main poison that violates the integrity of blood and heart cells;
• Scarlet erythrogenin - a toxin due to which capillaries expand, and a skin rash occurs with scarlet fever;
• Leukocidin - an enzyme that destroys immune blood cells - leukocytes, and thereby suppresses our natural defenses against infections;
• Necrotoxin and lethal toxin are poisons that cause tissue death;
• Hyaluronidase, amylase, streptokinase and proteinase are enzymes by which streptococci devour healthy tissue and spread throughout the body.

At the site of the introduction and growth of a colony of streptococci, a focus of inflammation arises, which worries a person with severe pain and edema. As the disease progresses, toxins and poisons secreted by bacteria are carried through the bloodstream throughout the body, therefore streptococcal infections are always accompanied by general malaise, and in severe cases - large-scale intoxication, up to vomiting, dehydration and clouding of consciousness. The lymphatic system reacts to the disease by engorgement of the lymph nodes located near the focus of inflammation.

Since streptococci themselves and their waste products are foreign to our body, the immune system reacts to them like a powerful allergen and tries to develop antibodies. The most dangerous consequence of this process is autoimmune diseases, when our body ceases to recognize the tissues changed by streptococcus and begins to attack them. Examples of severe complications: glomerulonephritis, rheumatoid arthritis, autoimmune inflammation of the membranes of the heart (endocarditis, myocarditis, pericarditis).

Streptococcus groups

Streptococci are divided into three groups according to the type of erythrocyte hemolysis:

• Alpha hemolytic or greening - Streptococcus viridans, Streptococcus pneumoniae;
• Beta hemolytic - Streptococcus pyogenes;
• Nonhemolytic - Streptococcus anhaemolyticus.

For medicine, it is streptococci of the second type, beta-hemolytic, that matter:

• Streptococcus pyogenes - the so-called pyogenic streptococci, which cause angina in adults and scarlet fever in children, and give serious complications in the form of glomerulonephritis, rheumatism and endocarditis;
• Streptococcus pneumoniae - pneumococci, which are the main culprits of pneumonia and sinusitis;
• Streptococcus faecalis and Streptococcus faecies - enterococci, the most tenacious bacteria of this family, causing purulent inflammation in the abdominal cavity and heart;
• Streptococcus agalactiae are bacteria responsible for most streptococcal lesions of the genitourinary organs and postnatal inflammation of the uterine endometrium in women in labor.

As for the first and third types of streptococci, greening and non-hemolytic, these are just saprophytic bacteria that feed on humans, but almost never cause serious diseases, because they do not have the ability to destroy red blood cells.

For the sake of fairness, it is worth mentioning a beneficial bacteria from this family - lactic acid streptococcus. With its help, dairy factories make everyone's favorite dairy products: kefir, yogurt, fermented baked milk, sour cream. The same microbe helps people with lactase deficiency - this is a rare disease that manifests itself in a deficiency of lactase, an enzyme necessary for the absorption of lactose, that is, milk sugar. Sometimes thermophilic streptococcus is given to infants to prevent severe regurgitation.

Streptococcus in adults

In adults, beta-hemolytic streptococcus most often causes acute tonsillitis, that is, sore throat, or pharyngitis, a less serious inflammation of the upper part of the oropharynx. Much less often, this bacteria causes otitis media, caries, pneumonia, dermatitis, erysipelas.

Pharyngitis

Pharyngitis caused by streptococcus always begins suddenly, because it has a very short incubation period, and is characterized by very vivid symptoms: sharp pain when swallowing, low-grade (low) temperature, chills and general weakness. The patient is so painful to swallow that sometimes he completely loses his appetite. Dyspeptic disorders rarely accompany streptococcal pharyngitis, but it is often complicated by the enlargement and soreness of the submandibular lymph nodes, hoarseness and superficial, dry cough.

At the reception, the therapist quickly diagnoses pharyngitis by visual examination of the pharynx: the mucous membrane is edematous, bright red, covered with a grayish coating, the tonsils are swollen, in some places scarlet follicles in the form of a donut are visible. Streptococcal pharyngitis is almost always combined with a runny nose, moreover, the mucus is transparent and so abundant that it can cause maceration (soaking) of the skin under the nose. The patient is prescribed local antiseptics for the throat in the form of a spray or lozenges; there is no need to take antibiotics inside.

Usually this disease goes away as suddenly as it began, and does not last long - 3-6 days. The victims of pharyngitis are mainly young people, or vice versa, elderly people with weakened immunity, who have come into contact with a sick person, used his dishes or a toothbrush. Although pharyngitis is considered a widespread and not serious disease, it can be very unpleasant complications.

The consequences of pharyngitis can be:

• Purulent otitis media
• Tonsillar abscess
• Sinusitis,
• Lymphadenitis;
• Arthritis;
• Osteomyelitis.

Angina

Streptococcal sore throat (acute tonsillitis) can turn into a real disaster for an adult patient, especially an elderly one, because untimely and poor-quality treatment of this disease often causes formidable complications on the heart, kidneys and joints.

Factors contributing to the development of acute streptococcal tonsillitis:

• Weakening of general and local immunity;
• Hypothermia;
• Recently suffered another bacterial or viral infection;
• The negative impact of external factors;
• Prolonged contact with a sick person and his household items.

Sore throat begins as suddenly as pharyngitis - the night before the patient becomes painful to swallow, and in the morning the throat is completely covered with infection. The toxins travel through the bloodstream throughout the body, causing swollen lymph nodes, high fever, chills, weakness, anxiety, and sometimes confusion and even seizures.

Sore throat symptoms:

• Severe sore throat;
• Febrile temperature
• Body aches;
• Headache;
• Submandibular lymphadenitis;
• Swelling and redness of the pharyngeal mucosa;
• Enlargement of the tonsils;
• The appearance on the mucous membrane of the throat of a loose grayish or yellowish plaque, and sometimes purulent plugs;
• In young children - dyspeptic disorders (diarrhea, nausea, vomiting);
• Blood tests show strong leukocytosis, C-reactive protein, accelerated ESR.

Streptococcal sore throat has two types of complications:

• Purulent - otitis media, sinusitis, flux;
• Non-purulent - rheumatism, glomerulonephritis, toxic shock syndrome, myocarditis, endocarditis, pericarditis.

Treatment of angina is carried out with the help of local antiseptics, but if the inflammation cannot be stopped within 3-5 days, and the body is seized with total intoxication, you have to resort to antibiotics to prevent complications.

Streptococcus in children

Streptococci are very dangerous for newborn babies: if intrauterine infection occurs, the child is born with a high fever, subcutaneous bruising, bloody discharge from the mouth, difficulty breathing, and sometimes with inflammation of the meninges. Despite the high level of development of modern perinatal medicine, it is not always possible to save such children.

All streptococcal infections in children are conventionally divided into two groups:

• Primary - tonsillitis, scarlet fever, otitis media, pharyngitis, laryngitis, impetigo;
• Secondary - rheumatoid arthritis, vasculitis, glomerulonephritis, endocarditis, sepsis.

The undisputed leaders in the incidence of morbidity in children are angina and scarlet fever. Some parents consider these diseases to be completely different, and some, on the contrary, confuse them with each other. In reality, scarlet fever is a severe form of streptococcal sore throat, accompanied by a skin rash.

Scarlet fever

The disease is very contagious, and spreads among children in kindergartens and schools at the speed of a forest fire. Scarlet fever usually affects children aged two to ten years, and only once, since a stable immunity is formed to the disease. It is important to understand that the cause of scarlet fever is not the streptococcus itself, but its erythrogenic toxin, which causes severe poisoning of the body up to the clouding of consciousness and a dotted red rash, by which the pediatrician can accurately distinguish scarlet fever from ordinary angina.

It is customary to distinguish three forms of scarlet fever:

• Mild - the disease lasts 3-5 days and is not accompanied by large-scale intoxication;
• Average - lasts a week, is distinguished by severe poisoning of the body and a large area of rashes;
• Severe - can drag on for several weeks and turn into one of the pathological forms: toxic or septic. Toxic scarlet fever is manifested by loss of consciousness, dehydration and convulsions, and septic scarlet fever is manifested by severe lymphadenitis and necrotizing angina.

Scarlet fever, like all streptococcal infections, has a short incubation period and affects the child suddenly, and lasts an average of 10 days.

Symptoms of scarlet fever:

• Fever, chills, body aches, headache, and severe pain when swallowing;
• Rapid pulse, tachycardia;
• General weakness, lethargy, drowsiness;
• Nausea, diarrhea, vomiting, dehydration, loss of appetite;
• A characteristic puffy face and an unhealthy shine of the conjunctiva;
• Very strong increase and soreness of the submandibular lymph nodes, up to the inability to open the mouth and swallow food;
• Redness of the skin and the appearance of small roseola or papules on them, first on the upper part of the body, and after a few days on the limbs. It looks like goose bumps, moreover, on the cheeks the rash merges and forms a scarlet crust;
• Blanching of the nasolabial triangle in combination with cherry lips;
• Coverage of the tongue with a gray coating, which disappears after three days, starting from the tip, and the entire surface becomes scarlet with protruding papillae. The tongue looks like a raspberry;
• Pastia Syndrome - an accumulation of a rash in the folds of the skin and a strong judgment;
• Clouding of consciousness up to fainting, less often - delirium, hallucinations and convulsions.

Painful symptoms increase during the first three days from the onset of the disease, and then gradually subside. The number and severity of the rash decreases, the skin becomes whitish and dry, sometimes in a child's palms and feet it comes off in whole layers. The body produces antibodies to erythrotoxin, so if children who have had scarlet fever again encounter the pathogen, this only leads to angina.

Scarlet fever is very dangerous for its complications: glomerulonephritis, inflammation of the heart muscle, vasculitis, chronic lymphadenitis.

The moderate and severe form of this disease requires adequate and timely antibacterial therapy, as well as careful care of the child and subsequent measures to strengthen his immunity, for example, rest in a sanatorium and a course of multivitamins.

Streptococcus in pregnant women

One of the reasons why expectant mothers should be very scrupulous about personal hygiene is streptococcus and staphylococcus, which can easily enter the genital tract with improper wiping, prolonged wearing of underwear, using non-sterile intimate hygiene products, touching the genitals with dirty hands, and unprotected sex. Of course, streptococcus is normally present in the vaginal microflora, but the body of a pregnant woman is weakened, and natural defense mechanisms may not be enough to contain the infection.

The norm of the content of opportunistic streptococci in a lubricant from the vagina of a pregnant woman is less than 104 CFU / ml.

The most important in the development of pregnancy pathology are the following streptococci:

• Streptococcus pyogenes causes angina, pyoderma, cystitis, endometritis, vulvitis, vaginitis, cervicitis, glomerulonephritis, postpartum sepsis, as well as intrauterine infection of the fetus with all the ensuing consequences;
• Streptococcus agalactiae can also cause endometritis and inflammatory diseases of the genitourinary organs in the mother, and in the newborn, cause meningitis, sepsis, pneumonia and neurological disorders.

If a dangerous concentration of streptococci is found in a smear in a pregnant woman, local sanitation is carried out using antibacterial suppositories. And with full-scale streptococcal infections, for example, angina, the situation is much worse, since most of the antibiotics to which streptococcus is sensitive are strictly contraindicated during pregnancy. The conclusion is banal: expectant mothers need to carefully take care of their health.

Complications and consequences of streptococcus

Streptococcal infections can cause the following complications:

• Suppurative otitis media;
• Severe allergies;
• Rheumatoid arthritis;
• Chronic lymphadenitis;
• Inflammation of the heart membranes - endocarditis, myocarditis, pericarditis;
• Pulpitis - inflammation of the contents of the teeth;
• Toxic shock syndrome;
• Glomerulonephritis;
• Acute rheumatic fever;
• Sepsis.

The mechanism for the development of complications of streptococcal infections is not fully understood, however, scientists believe that the phenomenon of cross-immunity is to blame, when antibodies developed to fight streptococcus take up arms against the body's own cells, altered by the pathogen.

Angina and pharyngitis are complicated by acute rheumatic fever in about 3% of cases. The decisive moment in preventing this formidable consequences of streptococcal infections is timely and adequate antibiotic therapy. Earlier, when in the arsenal of doctors there were not so many powerful and safe antibiotics, acute respiratory infections were very common, and became the cause of the death of young and healthy people from a common cold.

Acute glomerulonephritis, that is, autoimmune inflammation of the kidneys, develops in about 10% of patients 2-3 weeks after the untreated streptococcal infection. Children suffer from glomerulonephritis much more often than adults, but their disease is milder and usually does not cause fatal consequences.

The most dangerous for life and health are autoimmune lesions of the heart muscle, connective tissue and joints. Endocarditis sometimes develops into a heart defect and causes severe forms of heart failure. Rheumatoid arthritis is an incurable disease that gradually immobilizes a person and leads to death from suffocation. Fortunately, such formidable complications develop in less than 1% of cases of streptococcal infections.

Diagnosis of streptococcus

To diagnose streptococcal infections, tests of blood, urine, sputum, nasal mucus, scrapings from the surface of the skin (with erysipelas) and from the mucous membrane of the oropharynx (with pharyngitis and sore throat), as well as smears from the vagina or urethra in diseases of the genitourinary sphere are used.

The most common methods for diagnosing streptococcus are as follows:

• Using a sterile cotton swab, a laboratory assistant takes a swab from the throat surface, places the test material in blood agar and incubates for 24 hours in a closed flask at 37 ° C, then evaluates the result with a microscope, isolates a colony of bacteria with hemolysis and subcultures it into blood or sugar broth … There streptococci after three days give a pronounced near-bottom and parietal growth, and by the color and characteristic appearance of the colony, one can conclude about the serogroup of the pathogen and choose a suitable antibiotic;
• If there is a suspicion of sepsis, 5 ml of blood is taken from the patient and inoculated into sugar broth with thioglycol. The material is incubated at 37 ° C for eight days, subcultured twice on blood agar, on the fourth and eighth days. In a healthy person, the blood is sterile, and in the patient, the growth of bacterial colonies will be observed, by the nature of which one can conclude about the strain of the pathogen;
• The serodiagnostic method allows you to determine the presence of antibodies to streptococcus in the patient's blood, as well as their amount, and thus confirm or deny the diagnosis;
• Latex agglutination reaction and ELISA are methods of express diagnostics of streptococcal infections by blood;
• Differential diagnosis is necessary in order to distinguish a streptococcal infection from a very similar, staphylococcal infection.

Streptococci and staphylococci cause the same diseases in humans: angina, pharyngitis, dermatitis, otitis media, sepsis. The difference is only in the speed of development, the brightness of the symptoms and the severity of the disease.

For example, sore throat caused by streptococcus is much more contagious, manifests itself in very severe pain, often turns into a purulent form and causes complications. But Staphylococcus aureus is difficult to sanitize and constantly leads to reinfection of the patient.

Answers to important questions about streptococcus

Forewarned is forearmed. That is why most people, first of all, are trying to figure out how dangerous this or that bacterium is in practice, how to protect yourself from infection, and what exactly to do if you are faced with a pathogen. We will try to thoroughly answer the most common questions about streptococcus.

How is streptococcal infection spread?

The source of infection is almost always a sick person and his household items: dishes, a toothbrush, a towel, a handkerchief. It is almost impossible to pick up the bacteria from an asymptomatic carrier.

Streptococcus is transmitted in the following ways:

• Contact;
• Airborne droplets;
• Food;
• Sexual.

It is possible to cause a streptococcal infection of the genitals in oneself, if the basic rules of personal hygiene are not followed. But the most dangerous from the point of view of infection are people with sore throat or pharyngitis, with whom you are standing next to while talking, coughing and sneezing. In second place, you can put unwashed or stale food products that are brought into the body by streptococcus and cause dyspeptic disorders and food poisoning.

There are factors that significantly increase the likelihood of developing streptococcal infections:

• Endocrine pathologies;
• Immune diseases such as HIV
• Concomitant viral and anaerobic infections: ARVI, chlamydia, mycoplasmosis;
• Chronic gastrointestinal diseases: gastritis, ulcers, intestinal dysfunction.

Streptococcal infections are of a pronounced seasonal nature: this bacterium literally follows the viruses and spreads among people in late autumn and early winter, just during a wave of general incidence of acute respiratory infections and influenza. The worst part is that streptococcus significantly complicates the course of colds, but if the doctor did not diagnose it, then he will not prescribe antibiotics, because viruses are indifferent to them. That is why, with severe intoxication and a persistent course of a cold, it is imperative to be tested.

What is the difference between staphylococci and streptococci?

Staphylococcus aureus is a globular gram-positive anaerobic bacterium with a diameter of 0.5-1 microns. It has no organs of movement, does not produce spores. Some strains of staphylococcus are combined into capsules or form L-forms, that is, they completely or partially lose the cell membrane, but retain the ability to divide. Staphylococcus aureus is a conditionally pathogenic microbe, that is, it causes disease only under certain conditions, and the rest of the time it is simply present in the body, without showing itself. Surprisingly, all of these signs are characteristic of streptococcus. Same shape and diameter, same class of bacteria.

There are only a few signs by which you can distinguish staphylococcus from streptococcus:

• Staphylococci are grouped in irregular shapes in the form of bunches of grapes, less often stick together in pairs or stay alone. And streptococci always form pairs or line up in the correct chain;
• Staphylococci rarely form capsules, but in streptococci, almost all strains are encapsulated using hyaluronic acid membranes;
• Staphylococci rarely turn into L-forms, but streptococci do it very easily;
• Staphylococcus never becomes the cause of epidemiological outbreaks, and the diseases it causes develop only against the background of reduced immunity. Streptococcus, by contrast, is highly contagious, and often causes seasonal epidemics of the common cold.

Beta-hemolytic streptococcus is the culprit for 80% of all pharyngitis and tonsillitis, the remaining 20% of oropharyngeal diseases are caused by either staphylococcus or a combination of both bacteria.

Strep throat, what to do?

If you just have streptococcus in the analysis of a swab from the throat, you do not need to do absolutely nothing. It is not the test results that are treated, but the specific disease. Any person who has had pharyngitis or sore throat at least once has streptococcus on the mucous membrane of the throat, but as long as the immune system is at the proper level, nothing threatens you.

As we mentioned above, streptococcus belongs to conditionally pathogenic microorganisms, that is, it is an integral part of a healthy microflora. A healthy microflora is not one in which there are only “good” bacteria, but one where they are in balance. And if for a person himself, streptococcus is a "bad" bacterium, then one should not forget that it can be bad for some other representatives of the pathogenic flora and prevent them from multiplying. The enemy of my enemy is my friend.

The second reason why it is not necessary to touch streptococcus, found in the throat, but not causing disease, is the effect of adaptation to antibiotics. Attempts to inflict a "preemptive strike" against the infection result in the fact that bacteria do not completely disappear, but only adapt to antibacterial drugs, mutate and transmit genetic information about the enemy to their descendants. And then, when there is a really good reason to take antibiotics, the medication may be useless.

In a swab from the throat and nose of a healthy person, the following streptococci can normally be found:

• Streptococcus mutans;
• Streptococcus pyogenes;
• Streptococcus pneumoniae.

With any of the listed types of bacteria, you can and should get along peacefully. Even sucking lozenges for sore throat in the absence of it or spraying antibacterial sprays will bring enormous harm instead of benefit, not to mention taking oral antibiotics in tablets. With such preventive measures, you, together with streptococcus, will kill someone else, destroy the entire microflora of the pharynx and force your body to rebuild it. And it is not yet known what will come of this. Therefore, if streptococcus is simply present in your throat, do with it, as in the well-known saying: "do not touch it dashingly while it is quiet."

What does the presence of streptococcus in a vaginal smear mean?

In the vagina of a healthy woman, up to one hundred species of various microorganisms can live, including bacteria, protozoa parasites and fungi. And in almost every patient of a gynecologist, streptococci are found in a smear. But this is not a cause for alarm as long as the balance of the vaginal microflora is not disturbed.

From 95% to 98% of all microorganisms living in the female genital tract should be Doderlein sticks, and the share of opportunistic flora (streptococci, staphylococci, candida) should account for no more than 5%.

Keeping this rule in mind, a qualified doctor will never prescribe antibiotics to a patient, either locally or orally, if he simply sees streptococci in her smear. It is unreasonable to invade the microbiological balance of healthy genital organs for the same reason as in the case of the throat: if the existing background does not cause inflammation, then it does not need to be corrected.

The very presence of streptococcus in a vaginal smear may indicate the following processes:

• Peaceful coexistence of all representatives of microflora;
• Dysbacteriosis;
• Sexually transmitted infection.

If there are very few streptococci in the smear, and, on the contrary, there are many Doderlein sticks, then we are talking about the first option. If there are more streptococci than Doderlein's bacilli, but the number of leukocytes in the field of view does not exceed 50 pieces, we are talking about the second option, that is, about vaginal dysbiosis. Well, if there are many leukocytes, then a diagnosis of "bacterial vaginosis" is made, which is specified depending on the type of the main pathogen. It can be not only streptococcus, but also staphylococcus, herdnerella (gardnerellosis), Trichomonas (trichomoniasis), candidiasis (candidiasis), mycoplasma (mycoplasmosis), ureaplasma (ureaplasmosis), chlamydia (chlamydia) and many other microorganisms.

Thus, the treatment of streptococcus in the vagina, like the eradication of any other pathogen, is carried out only if its amount in the smear is disproportionately large and is accompanied by severe leukocytosis. All such genital infections have very vivid symptoms, and a smear examination is necessary in order to determine the culprit and select the appropriate antibiotic.

Streptococcus treatment

The treatment of streptococcal infections is dealt with by the specialist in whose area of responsibility the focus of inflammation is: a therapist will treat colds, scarlet fever - a pediatrician, dermatitis and erysipelas - a dermatologist, genitourinary infections - a gynecologist and urologist, and so on. In most cases, the patient is prescribed antibiotics from the group of semi-synthetic penicillins, but if they are allergic, they resort to macrolides, cephalosporins or lincosamides.

The following antibiotics are used to treat streptococcal infections:

• Benzylpenicillin - injection, 4-6 times a day;
• Phenoxymethylpenicillin - 750 mg for adults, and 375 mg for children twice a day;
• Amoxicillin (Flemoxin Solutab) and Augmentin (Amoxiclav) - in the same dosage;
• Azithromycin (Sumamed, Azitral) - for adults 500 mg once on the first day, then 250 mg every day, for children the dosage is calculated on the basis of 12 mg for each kg of weight;
• Cefuroxime - injection of 30 mg for each kg of body weight twice a day, orally 250-500 mg twice a day;
• Ceftazidime (Fortum) - by injection once a day, 100 - 150 mg per kg of body weight;
• Ceftriaxone - by injection once a day, 20 - 80 mg per kg of body weight;
• Cefotaxime - by injection once a day, 50-100 mg per kg of body weight, only if there is no effect from other antibiotics;
• Cefixim (Suprax) - orally 400 mg once a day;
• Josamycin - orally once a day, 40-50 mg per kg of body weight;
• Midecamycin (Macropen) - orally once a day, 40-50 mg per kg of body weight;
• Clarithromycin - orally once a day, 6 to 8 mg per kg of body weight;
• Roxithromycin - 6 - 8 mg orally for each kg of body weight;
• Spiramycin (Rovamycin) - orally twice a day, 100 units for each kg of weight;
• Erythromycin - orally four times a day, 50 mg per kg of body weight.

The standard course of treatment for streptococcal infection takes 7-10 days. It is very important not to stop taking the drug immediately after you feel better, to avoid gaps and not to change the dosage. All this becomes the cause of multiple relapses of the disease and significantly increases the risk of complications. In addition to intramuscular, intravenous, or oral antibiotics, topical antibacterial agents are used in the treatment of streptococcus in the form of aerosols, throat gargles, and sucking tablets. These drugs significantly accelerate recovery and ease the course of the disease.

The most effective topical medications for oropharyngeal streptococcal infections are:

• Ingalipt - sulfa antibacterial aerosol for the throat;
• Tonsilgon N is a local immunostimulant and antibiotic of plant origin in the form of drops and pills;
• Geksoral - antiseptic aerosol and throat rinse solution;
• Chlorhexidine is an antiseptic, sold separately as a solution, and is also included in many tablets for sore throat (Anti-Angina, Sebidina, Faringosept);
• Cetylpyridine - antiseptic, contained in Septolet tablets;
• Dichlorobenzene alcohol is an antiseptic, found in many aerosols and lozenges (Strepsils, Ajisept, Rinza, Lorsept, Suprima-ENT, Astrasept, Terasil);
• Iodine - found in aerosols and throat rinses (Iodinol, Vokadin, Yoks, Povidone-iodine).
• Lizobakt, Immunal, IRS-19, Imunoriks, Imudon - local and general immunostimulants.

If antibiotics were taken internally to treat streptococcal infection, drugs will be needed to restore the normal microflora of internal organs:

• Linex;
• Bifidumbacterin;
• Acipol;
• Bifiform.

Treatment of streptococcus in young children is carried out with the addition of antihistamines:

• Claritin;
• Cetrin;
• Zodak.

It would be useful to take preventive vitamin C, which strengthens the walls of blood vessels, helps to increase the immune status and detoxify the body. In difficult situations, doctors use a special streptococcal bacteriophage for treatment - this is an artificially created virus that devours streptococci. Before use, the bacteriophage is tested by placing it in a flask with the patient's blood and observing its effectiveness. The virus does not cope with all strains, sometimes it is necessary to resort to a combined pyobacteriophage. In any case, this measure is justified only when the infection cannot be stopped with antibiotics, or the patient is allergic to all topical types of antibacterial drugs.

It is very important to follow the correct regimen while treating streptococcal infections. A serious illness with severe intoxication of the body requires being in bed. It is active movements and work during the period of illness that are the main prerequisites for the development of serious complications in the heart, kidneys and joints. To remove toxins, you need a lot of water - up to three liters daily, both in pure form and in the form of warm medicinal tea, juices and fruit drinks. Warming compresses on the neck and ears can be applied only if the patient does not have an increased body temperature.

With streptococcal sore throat, it is categorically impossible to try to speed up recovery by ripping off purulent plaque and plugs from the mucous membrane of the throat with a bandage moistened with iodine or lugol. This will lead to the penetration of the pathogen even deeper and aggravation of the disease.

In acute tonsillitis and pharyngitis, you should not irritate the throat with too hot, or vice versa, with ice-cold food. Coarse food is also unacceptable - it injures the inflamed mucous membrane. It is best to eat porridge, mashed soups, yoghurts, soft curds. If the patient has no appetite at all, there is no need to stuff him with food, this will only result in nausea and vomiting. Digestion is a process in which our body spends a lot of energy. Therefore, during the treatment of streptococcal infection, when the digestive organs are already working poorly, and the body is poisoned by toxins, fasting with plenty of drink may be more useful than a good diet.

Of course, children suffering from streptococcal sore throat or scarlet fever need the most careful care. The child is given warm linden or chamomile tea every hour and a half, cool lotions are applied to sore eyes and a hot forehead, and itchy and flaky skin areas are smeared with baby cream. If the baby is able to gargle, you need to do it as often as possible using an infusion of chamomile or sage. After recovering from a severe form of scarlet fever, young patients are recommended to rest in a sanatorium, prophylactic intake of multivitamins, immunostimulants, pro- and prebiotics.

The author of the article: Lazarev Oleg Vladimirovich | ENT

Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)