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The patient was a 5-year old male who awoke on the day prior to evaluation with...

The patient was a 5-year old male who awoke on the day prior to evaluation with a sore throat and fever. His mother treated him symptomatically with Tylenol, and he stayed home. That night, he slept well, but the next day he awoke still complaining of sore throat and fever, as well as headache and abdominal pain. On physical examination, he had a fever, and his anterior pharynx and tonsils were red. His anterior cervical lymph nodes at the angle of the mandible were enlarged and tender. No skin lesions or rashes were seen. He did not have a cough, runny nose, or conjunctivitis. A rapid antigen test for Group A streptococci (GAS) was taken, and the results were positive. As a result, the clinician prescribed a 10-day course of oral amoxicillin.

Based on his clinical presentation, what organism was most likely causing this patient’s infection? Explain what bacterial virulence factors are important for the development of the sore throat.

Sore throat associated with a macupapular rash is frequently seen with this organism. What is this condition called? What virulence factors are responsible for this rash?

Was antimicrobial therapy necessary in this patient? Explain.

This patient is a risk for noninfectious sequelae. What are they? Describe our current understanding of the pathogenesis of these nonsuppurative sequelae. What bacterial virulence factors are important for the development of these diseases?

Solutions

Expert Solution

what organism was most likely causing this patient’s infection?

streptococcus pyogenes

Explain what bacterial virulence factors are important for the development of the sore throat.

1) M protein for binding

2) lipoteichoic acid for adherence

3) hyaluronic acid capsule to inhibit phagocytosis

4) Streptokinase

Sore throat associated with a macupapular rash is frequently seen with this organism. What is this condition called?

Scarlet fever

What virulence factors are responsible for this rash?

Pyrogenic toxin, which is an exotoxin

Was antimicrobial therapy necessary in this patient?

Yes

Explain.

Streptococcus is a very virulent organisms, it can lysis the connective tissue as well as the muscles leading fatal conditions

This patient is a risk for noninfectious sequelae. What are they?

1.acute rheumatic fever

2.acute glomerulonephritis

Describe our current understanding of the pathogenesis of these nonsuppurative sequelae.

It is based on molecular mimicry,

The pathogenic mechanisms is the molecular mimicry between streptococcal M protein and human cardiac myosin proteins iplay a role. Because of the structural similarities between the two proteins, antibodies and T cells activated to respond to streptococcal proteins also react with the human proteins, causing tissue injury and inflammation. In addition to nonspecific symptoms (e.g., fever, malaise, and fatigue), patients present with symptoms involving the heart (pancarditis), joints (migratory polyarthritis), skin (subcutaneous nodules, erythema marginatum), and/or CNS (Sydenham chorea).

What bacterial virulence factors are important for the development of these diseases?

M protein

Nightingale answered 1 year ago

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