NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes Streptococcal pharyngitis (Strep Throat)

NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes Streptococcal pharyngitis (Strep Throat)

There are several disorders that may mimic strep throat (Gottlieb, Long, Koyfman, 2018). However, I am confident that treating this patient for strep throat is a good decision.  Research indicates that strep throat may be genetically -connected, particularly among children who get strep throat frequently. It is believed that an antibody deficiency aberrant TFh cell is involved (Dan et al, 2019) NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes.

The cause of strep throat is group A hmoltic Streptococcus. Children may be at risk of developing strep throat for a number of reasons such as socializing crowded  places at school where someone else is infected, brushes their teeth where moist bacteria is found on uncleaned toothbrushes, and contaminated foods.In most cases, Beta-hemolytic streptocccus leads to acute pharyngiti NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes. The body initiates an inflamamatory response in the pharynx, which ultimately results in fever, pain vasodilation edema, and tissue swelling.

On the cellular level, the involvement of epithelial cells, neutrophils, macrophages, and dendritic cells , all secret inflammatory mediators. Th1 and Th17 responses  are involved in adaptive immunity in both murine models of GAS pharyngitis and tissues in the tonsil (Soderholm, Barnett, Sweet, & Walker, 2018). Another characteristic would not change my response to diagnosing this illness. This was a relatively strong case for strep throat. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

References

Dan, J., Daughton, C., Kendric, K., Al-Kolla, R., Kaushik, K.  (Feb. 2019). Recurrent group A Streptococcus tonsillitis is an immunosusceptibility disease involving antibody deficiency and aberrant TFH cells. Science Translational Medicine, 11, 478. doi:10.1126/scitranslmed.aau3776.

Gottlieb, M; Long, B; Koyfman, A (May 2018). Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics. The Journal of Emergency Medicine. 54 (5): 619–629. doi:10.1016/j.jemermed.2018.01.031

.Soderholm, A.T., Barnett, T.C., Sweet, M.J.,  & Walker, M.J. (2018). Group A streptococcal pharyngitis: Immune responses involved in bacterial clearance and GAS-associated immunopathologies. J Leukoc Biol.,103(2):193‐213. doi:10.1189/jlb.4MR0617-227RR

Responses

Thank you for sharing with us, your discussion post and I would like to offer a few pointers. Strep throat, also known as streptococcal pharyngitis, is caused by a bacterium called Group A streptococcus (GAS) (Centers for Disease Control and Prevention, 2018).  After infecting an individual, GAS lives in the nose or throat and can be easily transmitted as droplet infection through coughing and sneezing. Children are most susceptible to this disease because they tend to congregate in large groups as they play and are not up to the task on matters of hand hygiene.

Like you pointed out, studies have shown that recurrent infections of strep throat could point to a genetic connection. The antibody specific to fighting GAS is anti-streptococcal pyrogenic exotoxin (Anti-SpeA) and lack of it or any genetic alteration in the body of a child makes them vulnerable to infections.  “Recurrent Tonsillitis children exhibited reduced antibody responses to an important GAS virulence factor, streptococcal pyrogenic exotoxin A (SpeA)” (Dan et al, 2019). Children who are born with genetically transmitted immunocompromising conditions are also prone to infections like these. Cases include HIV, hemophilia, leukemia, neutropenia, and systemic lupus erythematosus (SLE).

References

Centers for Disease Control and Prevention (2018). GroupA streptococcal (GAS) Disease. Retrieved from https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Dan, J, M., Havenar-Daughton, C  Kendric, k., Al-Kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, N., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Lindestam, C. S., Alessandro A. S., Nizet, V., Bothwell, M., Brigger, M., 

& Crotty, S.(2019). Recurrent group A Streptococcus tonsillitis is an immune susceptibility disease involving antibody deficiency and aberrant TFH cells. Science translational medicine 11(478). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561727/