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http://dx.doi.org/10.1097/RHU.0b013e3181ca38bcDOI Listing

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Article Synopsis
  • A 71-year-old man experienced fever and joint pain after a recent throat infection, showing signs of group A streptococcal (GAS) infection with high antistreptolysin O (ASO) levels.
  • The case raised questions about whether he had acute rheumatic fever (ARF) or post-streptococcal reactive arthritis (PSReA), as he displayed symptoms of both conditions.
  • The authors highlight the need for careful consideration of ARF in patients with recent streptococcal infections and joint pain to ensure timely treatment and avoid complications.
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Background: Group A streptococci (Strep A) orStreptococcus pyogenes is a major human pathogen causing an estimated 500,000 deaths worldwide each year. Disease can range from mild pharyngitis to more severe infections, such as necrotizing fasciitis, septicemia, and toxic shock syndrome. Untreated, Strep A infection can lead to the serious post streptococcal pathologies of rheumatic fever/rheumatic heart disease and post-streptococcal glomerulonephritis.

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Article Synopsis
  • * PSGN is a complication from group A streptococcal infections, leading to symptoms like edema and hypertension, but can also be associated with neurological conditions due to similarities in the immune response.
  • * The patient was treated initially with corticosteroids and later intravenous immunoglobulin (IVIG), resulting in complete symptom resolution, emphasizing the need to consider ADEM in pediatric PSGN cases with neurological symptoms after throat infections.
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Group A ß-hemolytic Streptococcus (S. pyogenes), also known as GAS, is a Gram-positive bacterium. It can be easily identified in the microbiology laboratory by its ability to hemolyse blood in culture media.

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The COVID-19 pandemic has altered the epidemiology of many common childhood infections, including Group A streptococcal (GAS) disease. Acute post-streptococcal glomerulonephritis (APSGN) is a nonsuppurative complication of GAS pharyngitis and pyoderma. It remains the most common cause of pediatric acute glomerulonephritis globally.

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