Streptococcus is a bacterium that is often part of our microbial flora without causing ailments. Many of us are “healthy carriers” and this could already be of great comfort compared to our fears of contagion. We learn to recognize the symptoms to obtain early diagnosis even in children.
The epidemics from streptococcus among the children They are increasingly frequent and, with them, school alarms and concerns of families grow. What is streptococcus? Streptococcus, and specifically the Pyogenes (also called Beta-Emolithic Streptococcus of group A-Sbea) is a bacterium that is often part of our microbial flora without causing ailments. Many of us, according to some sources of up to 20 out of 100 people, are “healthy carriers“And this could already be of great comfort compared to our fears of contagion.
Even when this bacterium is the cause of pathology, however, the clinical paintings most frequently associated with Sbea infection are common and simple management. The diseases that most often follow streptococcal infection are represented by acute pharyngotonsillitis (and, more rarely, from its complications) and by Superinfection of skin lesions (like the impetus of the region of the diaper or more destructive but fortunately much less frequent paintings).
The “post-infectious syndromes” are rare, that is pathologies triggered by a previous infection by Streptococcus, in which, however, the bacterium is not the direct protagonist of the damage.
Having made this short premise, when it comes to streptococcal infection what creates most confusion is probably the discrepancy of approach to suspicious or positive cases. Let’s try to clarify.
Symptoms of streptococcus in children
What are the Features of streptococcus in children? The main clinical characteristics of the condition most commonly associated with infection by Streptococcus in childrenthe acute streptococcal pharyngitis are two: fever And Farringodynia (pain in the throat).
These have acute debut and often accompany hypertrophy tonsil (the tonsils are of increased volume, red and often covered with essuded/whitish secretions). Consequence is the loss of appetite, which creates a lot of fear in family members. It is also frequent to enlarge the lymph nodes located under the corner of the jaw, a sign of activating our defenses towards the infectious agent and therefore transient and subject to regression to healing.
In some cases, unleashed by a particular toxin, the skin can be covered with a rash scarlet. We will talk about “scarlet fever“, A condition in which there is also a language that looks like a strawberry (first white and then red) and a face reminiscent of a mask (the redness of the face saves the area around the mouth generating the so -called Filatov mask).
Others symptoms, (cough, conjunctivitis and “colds”) are more typically associated with infections by other agents (often viruses), it is therefore theabsence of cough In the presence of the other symptoms described that makes us think of streptococcus infection
As per the premise, some paintings that can follow the infection from streptococcus in the children They are the so-called “post-infectious” syndromes. Among the post-infectious sequences, which, however, are not direct complications of the (non-suppurative) infection, the best known are: the post-strokeptococcal glomerulonefrite (GN) and rheumatic fever. The post-stroptococcal GN is typically caused by the “nephritogenic” strains, it appears 1-3 weeks from one Streptococcal pharyngitis And it is characterized by reduction of the diuresis and edema -gonfiore- which cause weight gain.
Fortunately, most of the children who develop post -streptococcal gn recovers a normal renal function.
Moving on to Rheumatic feverwe know that it also presents itself in the weeks that follow an acute streptococcal pharyngitis (generally 14-21 days later) and that it manifests itself with symptoms that most often involve the joints and more rarely the heart and the nervous system.
How long the streptococcus lasts in children and what the causes are
The causes of streptococcus In children are to be found in the direct infection of this bacterium from person to person through saliva or secretions of an infected subject.
Symptomatic streptococcal infections can be contracted several times, because there are numerous types of streptococcus with which the child can get in touch (“Serum serum”). Once an infection has been overcome, healed depending on the cases with or without antibiotic therapy, it must therefore not be surprised if the pathology reappears. If it is diagnosed more than once, even in the same season, a Streptococcal pharyngotonsillitis have probably been Contracts different types.
As for the duration of the symptoms of the infection from streptococcus in the children, A study showed that 90% at 24h from the beginning of antibiotic therapy obtains the elimination of the pharyngeal level streptococcus, confirming the practice of maintaining theisolation for at least one day dAnd the children with Streptococcal or Scarlettina FarringotonSillitis after the therapy has been undertaken.
How do you take care of streptococcus in children?
Which are the Remedies for streptococcus in children? First of all it would be appropriate to implement proper prevention. If we have not been able to prevent contagion, it will only be to try to define or exclude diagnosis.
There diagnosis of infection from streptococcus in the children It can be placed according to different approaches. In Italy the latest indications published were proposed by the Emilia Romagna Region (“Dossier n. 253/2015 – Farringotonsillitis in pediatric age. Regional guideline“). According to the aforementioned guidelines (LG) in a child over two years of age with Farringodynia and suspect Streptococcal pharyngitis, a diagnostic approach with rapid test is recommended (which must be appropriately carried out by the medical staff with an adequate technique for a reliable outcome). What is done under two years? Under two years the risk of false positives is high, these children should therefore not be subjected to quick test.
What the treatment for the streptococcus in the children? According to the guidelines, the use of penicillins (and therefore in our context ofamoxicillin), remains, in the absence of allergy to the drug, first choice (with a dose of 50 mg per kilo a day divided into two doses for a time of 6 days). It is therefore good to emphasize that a delay in therapy even 9 days from the beginning of the symptoms does not involve increases risks Both of non-healing and complications and that a therapy lasting greater 6 days has no advantage neither in terms of effectiveness on clinical healing from pharyngitis, nor on the risk of development of post-infectious complications.
At the same time as the start of the antibiotic therapyif indicated, or exclusively the administration of paracetamol or of ibuprofen With the aim of alleviating the symptoms that make him suffer.
And if despite a positive swab and a clinical diagnosis of pharyngitis It was not found a improvement After antibiotic therapy? The guidelines tell us that if you do not observe a prompt response (after 24-48 hours) to antibiotic therapy it is likely that we are facing a patient with a ‘viral infection who was already a healthy bearer of streptococcus. Concluding, It is good to know that a term therapy No control tests are performedour healing criterion is the resolution of the clinic. Moreover, as has been said, in 9 out of 10 children the streptococcus is eliminated from the pharynx already 24h after the start of antibiotic therapy.
