tailieunhanh - Chapter 130. Streptococcal and Enterococcal Infections (Part 5)

Asymptomatic Pharyngeal Colonization with Gas: Treatment When a carrier is transmitting infection to others, attempts to eradicate carriage are warranted. Data are limited on the best regimen to clear GAS after penicillin alone has failed. The combination of penicillin V (500 mg four times daily for 10 days) and rifampin (600 mg twice daily for the last 4 days) has been used to eliminate pharyngeal carriage. A 10-day course of oral vancomycin (250 mg four times daily) and rifampin (600 mg twice daily) has eradicated rectal colonization. Scarlet Fever Scarlet fever consists of streptococcal infection, usually pharyngitis, accompanied by a characteristic. | Chapter 130. Streptococcal and Enterococcal Infections Part 5 Asymptomatic Pharyngeal Colonization with Gas Treatment When a carrier is transmitting infection to others attempts to eradicate carriage are warranted. Data are limited on the best regimen to clear GAS after penicillin alone has failed. The combination of penicillin V 500 mg four times daily for 10 days and rifampin 600 mg twice daily for the last 4 days has been used to eliminate pharyngeal carriage. A 10-day course of oral vancomycin 250 mg four times daily and rifampin 600 mg twice daily has eradicated rectal colonization. Scarlet Fever Scarlet fever consists of streptococcal infection usually pharyngitis accompanied by a characteristic rash Fig. 130-2 . The rash arises from the effects of one of three toxins currently designated streptococcal pyrogenic exotoxins A B and C and previously known as erythrogenic or scarlet fever toxins. In the past scarlet fever was thought to reflect infection of an individual lacking toxin-specific immunity with a toxin-producing strain of GAS. Susceptibility to scarlet fever was correlated with results of the Dick test in which a small amount of erythrogenic toxin injected intradermally produced local erythema in susceptible individuals but elicited no reaction in those with specific immunity. Subsequent studies have suggested that development of the scarlet fever rash may reflect a hypersensitivity reaction requiring prior exposure to the toxin. For reasons that are not clear scarlet fever has become less common in recent years although strains of GAS that produce pyrogenic exotoxins continue to be prevalent in the population. Figure 130-2 FlUil AS. K fp r DL riụr ư ld t_. H uỉ f SU Lửngp DL- Jjmtfpn JU Latuke Jí .7-0 01 27 foaí . . ooe . 17th Edition h tpi Copyright ij Th- c rripirmiF_. Inc . All right. tQĩ i-ue d. Scarlet fever exanthem. Finely punctate erythema has become confluent scarlatiniform petechiae can occur and