Vu My Linh D., Rajnik Michael
Uniformed Services University of the Health Sciences
Uniformed Service University of the Health Sciences
formerly known asis a gram-positive, facultative, anaerobic, catalase-negative, β-hemolytic bacillus known for its ability to inhibit hemolysis of in the Christie-Atkins-Munch-Peterson (CAMP) test and to enhance hemolysis of in the reverse CAMP test. The initial cases reported with this pathogen in 1946 involved acute pharyngitis and ulcerative skin lesions among American soldiers in the Pacific Islands. Most infections caused by have been related to head and neck infections, such as acute pharyngitis and sinusitis, primarily in children and adolescents, and skin and soft-tissue infections, mainly in immunocompromised populations. However, can also rarely cause other types of infections, including bacteremia, endocarditis, osteomyelitis, severe sepsis, brain abscesses, and pneumonia. Distinguishing the cause of acute pharyngitis between viruses and bacteria can be challenging without culture confirmation. is the most common cause of acute pharyngitis, whereas has an incidence of up to 2.5%. However, the clinical presentation of both these bacteria can be almost indistinguishable. Therefore, should always be included in the differential diagnosis of acute pharyngitis to ensure accurate diagnosis and appropriate treatment. The clinical manifestations of pharyngitis include sore throat, fever, and a pruritic "sandpaper" scarlatiniform rash, which may be confused with pharyngitis and its scarlet fever rash. Delays in diagnosing infections occur due to similarities in clinical presentation between and , as well as the potential misinterpretation of the scarlatiniform rash as either the scarlet fever rash or a viral exanthem. Delays can also occur because the β-hemolysis caused by can take 48 to 72 hours to manifest, compared to up to 24 hours for , and this delay may go unnoticed. In addition, is more challenging to isolate in culture, contributing to diagnostic challenges. Prompt recognition and treatment with antibiotics such as penicillins, macrolides, or tetracyclines, along with supportive care, are crucial for achieving favorable patient outcomes without long-term sequelae.
以前称为……是一种革兰氏阳性、兼性厌氧、过氧化氢酶阴性、β溶血的杆菌，以其在克里斯蒂-阿特金斯-芒奇-彼得森（CAMP）试验中抑制溶血以及在反向CAMP试验中增强溶血的能力而闻名。1946年首次报道的该病原体病例涉及太平洋岛屿上美国士兵中的急性咽炎和溃疡性皮肤病变。由……引起的大多数感染与头颈部感染有关，如主要发生在儿童和青少年中的急性咽炎和鼻窦炎，以及主要发生在免疫功能低下人群中的皮肤和软组织感染。然而，……也很少引起其他类型的感染，包括菌血症、心内膜炎、骨髓炎、严重脓毒症、脑脓肿和肺炎。在没有培养确认的情况下，区分病毒和细菌引起的急性咽炎的病因可能具有挑战性。……是急性咽炎最常见的病因，而……的发病率高达2.5%。然而，这两种细菌的临床表现几乎无法区分。因此，在急性咽炎的鉴别诊断中应始终考虑……，以确保准确诊断和适当治疗。……咽炎的临床表现包括喉咙痛、发热和瘙痒的“砂纸样”猩红热样皮疹，这可能与……咽炎及其猩红热皮疹相混淆。由于……和……的临床表现相似，以及对猩红热样皮疹可能误判为猩红热皮疹或病毒疹，导致……感染的诊断延迟。延迟也可能发生，因为……引起的β溶血可能需要48至72小时才会显现，而……则最多需要24小时，这种延迟可能未被注意到。此外，……在培养中更难分离，这也增加了诊断的挑战。及时识别并用青霉素、大环内酯类或四环素类抗生素进行治疗，同时给予支持性护理，对于实现良好的患者预后且无长期后遗症至关重要。
