EÉIÉ

Ct's
STREPTOCOCAL SORE THROAT - TONSILITIS
pharyngitis
MENINGITIS

Streptococcus pyogen :130 serotypes Neiserria meningitis

perish rapidly outsidebody heat sad
Causative agents

Group A beta haemolytic gram + cocci arranged in chains Polysac.. capsular antigen :
A : carbohydrate classification A.B.C.E.W135.X.Y.Z
Beta : complete hemolysis group A epidemic
Moderatelyresistantoutsidebody
I
group B.C sporadic
ending
group W135 :new-epidemic
Human : case and carrier Human only : Case and carrier
Reservoir

Case : typical atypical , mild-moderate-sever Case : typical-Atypical

Carrier : Carrier:IMP : 5:10% found commensial asymptomatic in nasopharynx
Animal : in milk excretion only If reach 20% is dangerous to be outbreak or epidemic
No soil No animal
No soil sot iscarriers in acne epidemic

Respiratory discharge Respiratory discharge

Exit

throat
P.O.C

Through IP + clinical period

variableperiod -Undetectable but when no meningococci in nasopharengeal swab
of
convalascule notinfective in ID
Direct droplet
I H Direct : droplet infection major route
MOT

In direct ( droplet nuclei dust milk article & fomites ) Indirect Minor : -droplet nuclei

Milk 1:3 Days

-no Dust particles
2:10 days
II
inlet IP

Respiratory airway Respiratory airway

Environment :overcrowding no prober ventilation low socioeconomic Environment :overcrowding no prober ventilation low socioeconomic
susceptibility

Agent : type specific immunity Agent : type specific immunity

Host : age : 5:15 Host : age : children ,young adults 5:15
Ye
Sex : Genderly:both are same Sex : Genderly:both are same
Enviromently : male most to E
Seosonal : more in late winter and spring , meningiococcal become epidemic every
10y
a
varietyof disease accordingto
interyportal invasion oftissues
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toxin product
 FAHM
m t
1st stage: nasopharyngitis : FAHM +sore throat
2nd stage: meningococcemia:
yellowish
Enlarged follicular purulent tonsils
headed
CP

FAHM +nausea.vomiting+stiffness of neck with petechial rash wirh pink macules

3rd stage:CNS affection: Meningitis,delirium,sensitivity to light
come
CN affection , mental retardation, paralysis, pneumonia ,myocarditis, otitis media
III
Autoimmune : RHD Rheumatic fever, acute
diagnosis Complication

glomerulonephritis NB:TRIAD of meningitis is

Otitis media ,bronchitis, etc
Itai 1. Headache
2. Neck stiffness
3. Blurred vision
Maryselflimited sat I
CP + lab diagnosis :
fatality
CP + lab diagnosis :
s
Specific: throat swabbing + isolation Specific: CSF specimen culture
Non specific : Antistreptolysin O rising Non specific : high WBCs -CRP

General : Health promotion education environmental sanitation General : Health promotion education environmental sanitation in droplet
prevention

in droplet infection infection

CA Y C WBS
Specific : vaccines : no under
trail
Chemoprophlaxis: high risk contacts : penicillin long acting for 8
Specific : vaccines from 8 poly saccharides
a
-may conjugate to give 5:7 y
Long casting
subtypes until 3y
se
earsdose every 3 weeks in summer (low s)
5ydose every 2 weeks in winter(high susceptibility) Chemoprophlaxis: high risk contacts : rifampicin
twice aday
Case: finding-notification-isolation after 1 day of ttt -disinfection Case: finding-notification-isolation after 1 day of ttt -disinfection concurrent,
concurrent, terminal- treatment : penicillin 10 days to avoid RF - terminal- treatment : penicillin parentally-release after normal CSF picture
RHD-release after throat swabbing
Contacts: enlistment gang Contacts: enlistment
surveillance to maximum IP
control

surveillance to maximum IP vasopharengal that swab specific

specific novalue
laxis penicillin 10 days No vaccine postexposure
No vaccine postexposure Community control
Community control surveillance
massimm scary diagnosis
vaccine
chemotherapy

mascmmepr.ph rifanbice
O
Scarlet Fever
o
S : streptococcal focus in sore throat majorly and surgical wound , female
R : rash: punctate erythrema blanching in pressure, internal and external
RHD + RF complication
genital system+ strawberry tongue s puerperal L : low incidence in Egypt due to reporting + missing cases + acquired
C : circumoral pallor
i in childhood Immunity
A : AntiBacterial immunity type specific + Antitoxin immunity lifelong E : erythrogenic exotoxin
immunity T : tongue strawberry

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n
 t Re a e it D
s.IE s a Non suppurative systemic complication
of strept pyogenic
enlarged tonsils Wh
purulentspots
follicular II Major public health problem
4th Y1h
event
Natand
Adherent
disturb naval probes ofdevelopment
unilateral
susep o 5 15 Years
Bothsets but q R Chorea A
Mitral stenosis
Genitic More in some BreadGroup same
histo compatible
og
T in coldMonth as scarlet fever