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Group A beta hemolytic streptococcus commonest cause of skin inf Colonization of unbroken skin by GABS precedes pyoderma by 10 days Intradermal inoculation by insect bite, scabies or minor trauma leads to impetigo, ecthyma &cellulitis
S.Pyogenes
Noninvasive strains
Invasive trainss
impetigo
pharyngitis
Pyrogenic exotoxins
proteinase
Spreading factors
nephritogenic
Rheumatogenic strain
Scarlet fever
Necrotizing cellulitis/fascitis
Cellulitis erysipelas
psgn
Rheumatic fever
Impetigo: bullous non bullous Non bullous accts for >70% of the cases Tiny vesicle or pustule forms and rapidly develops into a honey colored crusted plaque Inf spreads by towels, fingers, clothings
Contact sports
Bullous impetigo: infants and young children Caused by coagulase-positive staph aureus Flaccid transparent bullae develop on the skin of face, buttocks, trunk, perineum, & extremities. Neonatal bullous impetigo can begin in the diaper area
Culture of fluid from an intact blister should yield the causative lesion. Complications are potential but rare: OM septic arthritis,pneumonia &septicemia
Deeper soft tissue inf may occur. Erysipelas is an acute well demarcated inf of the skin with lymphagitis involving the face (ass with pharyngitis) &extremities (wounds). The skin is erythematous &indurated The advancing borders are raised& firm Ass with fever, vomiting& irritability
CELLULITIS Strept cellulitis is a painful, erythematous, indurated inf of the skin and subcut tissue usually follows some injury to the skin Proteinase producing strain causes a more severe type of necrotizing fascitis or myositis Also more common in diabetics & immunocompr
Vaginitis :beta hemolytic strep. Are a common cause of vaginitis in prepubertal girls.pts usually have a serous discharge& marked erythema & irritation of the vulvar area,discomfort in walking &urination
Perianal dis: perianal strep cellulitis produces local itching,pain,blood streaked stools, erythema & proctitis.
Lesions may be as large as 4 cm Frequently on legs Predisposing factors :as impetigo Causative agent: GABHS (staph is cultured sec pathogen) Crust softened by warm compressions & removed by antibact soap Syst antibiotic tt as in impetigo
Lupus vulgaris