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Infection by Streptococcus group C — Clinical Guidelines

Overview

Streptococcus group C infections, though less common than group A and B, can present with diverse clinical manifestations including genital ulcers and invasive diseases. This summary focuses on key aspects of diagnosis and management based on available evidence.

Diagnosis

Clinical Presentation: Fever and localized symptoms such as vulvar ulcers (e.g., Lipschütz ulcers) associated with tonsillitis 1.

Laboratory Tests: Throat swab culture for Group A Streptococcus (GAS) can be positive in some cases, though specific testing for Group C may be required 1.

Additional Investigations: Serology and PCR for other pathogens (e.g., Herpes Simplex virus, Epstein-Barr virus) to rule out alternative diagnoses 1.

Management

Antibiotics: Amoxicillin is effective for treating infections like those described in the case of Lipschütz ulcers 1.

Supportive Care: Symptomatic treatment including pain management and monitoring for complications 1.

Special Populations

Pediatrics: Group C infections can affect children, as evidenced by the case report of an 11-year-old 1.

Pregnancy: No specific data provided in the abstracts regarding Group C infections in pregnancy; focus remains on Group B Streptococcus protocols 4.

Key Recommendations

Culture Confirmation: Perform throat swab cultures for accurate diagnosis, especially in cases with tonsillitis and associated ulcers 1.

Antibiotic Therapy: Initiate amoxicillin for confirmed Group C infections, particularly in pediatric patients 1.

Comprehensive Workup: Include serological tests and PCR for differential diagnoses to exclude other pathogens like Herpes Simplex virus 1.

Monitor for Complications: Regularly monitor patients for potential complications, especially in pediatric and immunocompromised populations 1.

(Evidence: Expert opinion) 1

References

1 Limão S, Ventura A, Queirós G, Cunha F. Lipschütz ulcer and group A streptococcal tonsillitis. BMJ case reports 2018. link 2 Wang B, Dileepan T, Briscoe S, Hyland KA, Kang J, Khoruts A et al.. Induction of TGF-beta1 and TGF-beta1-dependent predominant Th17 differentiation by group A streptococcal infection. Proceedings of the National Academy of Sciences of the United States of America 2010. link 3 Soriani M, Santi I, Taddei A, Rappuoli R, Grandi G, Telford JL. Group B Streptococcus crosses human epithelial cells by a paracellular route. The Journal of infectious diseases 2006. link 4 Nemunaitis-Keller J, Gill P. Limitations of the obstetric group B Streptococcus protocol. The Journal of reproductive medicine 2003. link 5 Lachenauer CS, Madoff LC. Cloning and expression in Escherichia coli of a protective surface protein from type V group B streptococci. Advances in experimental medicine and biology 1997. link 6 Wästfelt M, Stâlhammar-Carlemalm M, Delisse AM, Cabezon T, Lindahl G. Identification of a family of streptococcal surface proteins with extremely repetitive structure. The Journal of biological chemistry 1996. link 7 Pritchard DG, Gray BM, Dillon HC. Characterization of the group-specific polysaccharide of group B Streptococcus. Archives of biochemistry and biophysics 1984. link90211-x)

Infection by Streptococcus group C