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Blood Infection

Although the number of bloodstream infections (septicemia) of Group A strep appears to be on the rise, they are still extremely rare. Only about 4 to 5 people out of 100,000 develop these infections each year, according to the national Centers for Disease Control in Atlanta. But nearly one-third of all patients with Streptoccocus blood infections will die from them.

Septicemia usually gets its start when streptococcal bacteria on the skin delve into an opening as large as a surgical or battle wound or as small as a minor cut or scrape. Normally, the body's immune system checks these bloodstream invaders before they wreak havoc in the body. In those individuals whose resistance is lowered, however, Streptoccocus travels far and wide, causing such symptoms as fever, low blood pressure, chills, confusion, diarrhea, vomiting, or a red skin rash. Septicemia usually afflicts people over 60 who have an underlying disease such as diabetes or renal failure that compromises their immune defenses.

In addition to relying on clinical signs to diagnose septicemia, physicians use laboratory findings, including positive blood cultures, positive antibody tests, and extremely high numbers of white blood cells in the blood.

Toxic Streptococcal Syndrome

The new toxic streptococcal syndrome, first described in 1987 in this country, is similar to septicemia. Patients with this disorder have many of the same symptoms as those of septicemia, but because of the disease's rapid progression, by the time they seek treatment they are often gravely ill. Toxic streptococcal syndrome patients frequently go into shock and experience multi-organ failure, as well as complications such as the pneumonia that reportedly killed Jim Henson.

Only 1 or 2 people out of 100,000 fall prey to toxic streptococcal syndrome each year. Unlike septicemics, most of these patients don't have any underlying diseases hampering their immune defenses. Of 21 cases studied extensively by researchers, most patients were in their 30s and the youngest was 25 years old.

"The individuals who are getting strep septicemia and toxic strep syndrome," points out CDC epidemiologist Walter Straus, "are not the same ones who are getting strep throat."

Patients with toxic streptococcal syndrome are treated with antibiotics as well as with medical measures aimed at curbing the severe complications of the disease. The sooner patients are treated with antibiotics, the more likely they will recover from the syndrome, which kills about one-third of its victims.

Whether Group A Streptococcus infects the skin, blood, internal organs, or the throat, it is usually checked by prompt and appropriate antibiotic therapy. This is why, though recent outbreaks of serious strep infections are cause for some concern, they are not likely to prompt the extensive death or debilitation once tied to them.

Signs of a Group A Strep Infection

• sore throat accompanied by fever
• chest pain
• shortness of breath
• shock
• red rash accompanied by fever
• tender joints
• involuntary jerky movements
• blood in urine
• yellow flaky crusts on the skin
• puffy face and malaise

Persons developing any of these symptoms should seek immediate medical care.

The Streptococci Family

The streptococcal bacteria are extremely versatile and common. Able to invade almost any part of the body, streptococci cause a host of diseases. These microbes are divided into more than a dozen different groups, based on the proteins they harbor in their cell walls and their performance on various laboratory tests. Here's a list of some of the more troublesome categories or species of Streptococcus and the diseases for which they are well known:

Group A: strep throat, scarlet fever, rheumatic fever, impetigo, toxic streptococcal syndrome, streptococcal kidney disease, blood infections

Group B: blood infections in newborns, meningitis, childbed fever

Groups C, D, G, H, K: urinary tract infections, heart infections, meningitis, upper and lower respiratory tract infections

Streptococcus mutans: dental caries (cavities)

Streptococcus pneumoniae: pneumonia, ear infections, meningitis, sinus infections.

About the Author

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