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There may be tiny pinpoint red marks on the soft palate referred to as petechiae. ... PANDAS. PANDAS- Pediatric Autoimmune Neuropsychiatric Disorders Associated with ... – PowerPoint PPT presentation

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  • GROUP A and B

Group B Streptococcus
  • Group B Streptococcus is a bacterial infection of
    Streptococcus agalactiae. It is a facultative
    anaerobic bacteria that is gram positive with a
    cocci morphology found in chains. Many GBS
    strains are mainly encapsulated and are then
    serologically classified according to the
    presence of type-specific capsular
    polysaccharides. These capsules are important
    virulence factors and stimulators of
    antibody-associated immunity.

Group B Streptococcus in the Neonate Early and
  • Transmission of bacteria from mother to newborn
    occurs when the baby passes through the birth
    canal and comes into contact with the mothers
    epithelial cells.
  • Early-onset GBS is more dangerous and usually
    starts with a fever or abnormally low
    temperature, difficulty feeding, lethargy,
    breathing difficulties, rapid heart rate or slow
    heart rate. The most life threatening forms of
    infection are pneumonia, sepsis, and meningitis.

Group B Streptococcus in the Neonate Early and
  • Late-onset disease is similar to early-onset, yet
    less severe.
  • Test- Blood cx, CSF cx, urine cx, CBC, chest
    x-ray, ABGs, and coagulation studies.
  • Treatment- IV antibiotics, IV fluid, and
    medications to reverse shock, oxygen therapy,
    correction of clotting abnormalities and assisted

Prevention and Treatment of GBS the pregnant
  • Risk-based approach- Emphasizes preventive
    treatment for expectant woman who are at high
    risk for GBS transmission. A previous infant
    with invasive GBS, delivering at lt 37 weeks
    gestation, having an intrapartum temperature ?
    100.4F, or rupture of membranes for ? 18 hours
    according to the CDC. If a woman meet one or
    more of these criteria, the recommended treatment
    is to administer penicillin as and intrapartum

Prevention and Treatment of GBS the pregnant
  • Culture-based screening approach- Testing for GBS
    in an expectant mothers 35-37 week of pregnancy.
  • Collection of lower vaginal and rectal cultures.
  • If a woman tests positive for GBS and is
    determined to be a carrier, she is offered
    intrapartum chemoprophylaxis, based on the test
  • Neonates born to these mothers with GBS
    colonization should be monitored for 24 hours for
    signs of sepsis.

Group A Streptococcus
  • Group A Streptococcal pharyngitis is an acute
    infection of the oropharynx and or nasopharynx.
    It is a gram-positive cocci that tends to grow in
    pairs and short chains. It can be identified by
    their sensitivity to bacitracin.

Group A Streptococcus
  • Signs and Symptoms
  • Often described as a sore scratchy throat,
    febrile with swollen glands and, especially in
    children, nausea and/or vomiting.
  • There is a marked increase in redness and
    swelling of the tonsils possibly accompanied by
    white patches or streaks on the tonsils.
  • The patient may have difficulty swallowing, and
    enlarged lymph glands in the neck.

Group A Streptococcus
  • There may be tiny pinpoint red marks on the soft
    palate referred to as petechiae.
  • Other findings may include a beefy red swollen
    uvula, excoriated nares (especially in infants),
    and a scarlitiniform rash.

Group A Streptococcus
  • For the clinician to make a definitive diagnosis,
    he or she must do a throat culture.
  • Rapid Strep Antigen
  • Blood agar culture

  • Management of Group A Streptococcal Pharyngitis

Management of Group A Streptococcal Pharyngitis
  • Complications
  • Peritonsillar abcess
  • Scarlet fever
  • Poststreptococcal glomerulonephritis
  • Rheumatic fever

  • PANDAS- Pediatric Autoimmune Neuropsychiatric
    Disorders Associated with Streptococcal Infection
  • Case Study
  • Two year, nine month old male presents in the
    Emergency Department with inconsolable crying for
    one day.

  • Diagnositic Criteria for PANDAS
  • 1. Presence of Obsessive-compulsive disorder
    and/or a tic disorder
  • 2. Pediatric onset of symptoms (age 3 years to
  • 3. Episodic course of symptom severity
  • 4. Association with Group A Beta-Hemolytic
    Streptococcal infection ( a positive throat
    culture for strep or history of scarlet fever)
  • 5. Association with neurological abnormalities
    (motoric hyperactivity, or adventitious
    movements, such as choreiform movements