Cardiac and non-cardiac manifestations of infection caused by group A β-hemolytic Streptococcus

Abstract

Infection caused by group A β-hemolytic Streptococcus (GABHS) is characterized by significant diversity of clinical presentations accounted for by different GABHS strains and individual patients’ predisposition to immune inflammation. This paper reviews current data on streptococcal infection and poststreptococcal cardiac and non-cardiac complications and describes early diagnostic tools. Superficial infections are the most common forms (particularly in pediatrics) manifested as pharyngitis, tonsillitis, otitis, or sinusitis. Invasive infections (pneumonia, necrotizing fasciitis) are potentially lethal conditions accompanied by bacteremia and generalized inflammation. Strains producing exotoxins (GABHS superantigens) provoke scarlet fever and streptococcal toxic shock syndrome. The primary burden of cardiac complications of GABHS infections is still chronic rheumatic heart disease resulting from undiagnosed and untreated acute rheumatic fever. Valvulitis underlying cardiac complications have a subclinical course, requiring echocardiography to establish the diagnosis. Antibacterial treatment with β-lactam antibiotics as a first-line treatment for GABHS infection and prevention of cardiac and non-cardiac complications increase the relevance of early etiological diagnosis. These tools are clinical syndrome scale, culture, and rapid diagnostic tests based on streptococcal DNA and antigen detection. KEYWORDS: group A β-hemolytic Streptococcus, manifestations and complications of streptococcal infections, acute rheumatic fever, chronic rheumatic heart disease. FOR CITATION: Santalova G.V., Lebedev P.A., Garanin A.A. et al. Cardiac and non-cardiac manifestations of infection caused bygroup A β-hemolytic Streptococcus. Russian Journal of Woman and Child Health. 2022;5(1):63–71 (in Russ.). DOI: 10.32364/2618-8430-2022-5-1-63-71.