Erysipela, cellulitis and other Streptococcus pyogenes skin infections

Incidence and gravity: Invasive Streptococcus pyogenes infections are a com mon reason for hospitalization. Serious farms may occur in patients with no known risk factor, including young patients. Inversely, erysipela is obser ved more readily in the elderly population with a more vulnerable Venous sy stem. Disease gravity is related to the high risk of recurrence. For cellul itis, predominantly a disease of young subjects with no past history, sever ity is related to local extension and deve lopment of shock syndrome. Besid es the immediate life-threatening situation, functional prognosis may be co mpromised, depending an the localization of the infection. I Pathogenesis of group A streptococcal infections: Adherence and invasion pr operties of group A streptococci, particularly the capsule and protein M, a s well as streptococcal toxins cause severe septic and toxinic syndromes. S trains most frequently associated with invasive infections are: biotype 1, serotype M1 and biotype 3, serotype M3. Treatment: An antibiotic regimen by intravenous infusion of penicillin G is the gold standard treatment. Clindamycin should be added in case of septic shock Extensive cellulitis or necrotizing fasciitis requires surgical debr idement of the necrotic tissue and intensive care for the shock syndrome.