β-HEMOLYTIC STREPTOCOCCUS GROUP A CARRIER IN CHILDREN: THE PROBLEM OF DIFFERENTIAL DIAGNOSIS
https://doi.org/10.22627/2072-8107-2018-17-2-52-57
Abstract
Streptococcal infection is characterized by a variety of manifestations from asymptomatic carriage of the pathogen to manifest forms. Recently, in addition to the bacteriological method for confirming streptococcal etiology, the rapid test for β-hemolytic streptococcus group A is increasingly being used. Isolation of streptococci does not always indicate their involvement in pathology, quite often a person is a healthy carrier of the pathogen. The share of carrier is 10—28% of cases. However, in the practical activities of a physician, positive tests for β -hemolytic streptococcus group A (rapid test or bacteriological culture) are often treated as acute streptococcal infection even in children without any clinical manifestations of acute tonsillopharyngitis and, as a result, antibiotic therapy is prescribed.
For differential diagnosis, a correct evaluation of epidemiological and clinical data with a mandatory serological test — the determination of ASO in paired sera with an interval of 7—10 days is required. Absence of an increase in antibodies indicates carrier.
b-hemolytic streptococcus group A carriers in most cases do not need antibiotic therapy. However, if there is a history or risk of developing rheumatic fever, acute poststreptococcal glomerulonephritis, antibiotic therapy is necessary.
The authors proposed an algorithm for managing patients with the release of b-hemolytic streptococcus group A from the oropharynx.
About the Authors
E. V. Novosad
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Ekaterina Novosad, Ph.D., Associate Professor of the Department of Infectious Diseases in Children
Moscow
S. L. Bevza
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Svetlana Bevza, PhD, main laboratory assistant of the Department of Infectious Diseases in Children
Moscow
N. M. Obolskaya
Treatment and Rehabilitation Center of the Ministry of Economic Development of Russia
Russian Federation
Russian Federation
Natalia Obolskaya, PhD, deputy сhief medical officer
Moscow
O. V. Shamsheva
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Olga Shamsheva, MD, Professor, Head of the Department of Infectious Diseases in Children
Moscow
V. V. Belimenko
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Vladislav Belimenko, Ph.D., leading research assistant of the laboratory of protozoology
Moscow
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Review
For citations:
Novosad E.V., Bevza S.L., Obolskaya N.M., Shamsheva O.V., Belimenko V.V. β-HEMOLYTIC STREPTOCOCCUS GROUP A CARRIER IN CHILDREN: THE PROBLEM OF DIFFERENTIAL DIAGNOSIS. CHILDREN INFECTIONS. 2018;17(2):52-57. (In Russ.) https://doi.org/10.22627/2072-8107-2018-17-2-52-57
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