β-HEMOLYTIC STREPTOCOCCUS GROUP A CARRIER IN CHILDREN: THE PROBLEM OF DIFFERENTIAL DIAGNOSIS

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.

Keywords

• β-hemolytic streptococcus group a
• β-hemolytic streptococcus group a-carrier
• children
• s. pyogenes