Sketchy Microbiology: Group A Streptococcus (Streptococcus Pyogenes)

The Pie Genies’ Bakery – Group A Streptococcus (Streptococcus pyogenes)

Hint: Entire Picture

Pie under glass capsule – Group A Strep is encapsulated

Hint: Hot Apple

Hot Apple – Capsule made out of Hyaluronic Acid

Heating Lamp w/ “B” Light – Beta Hemolytic

Hint: Baker 1

Baker 1 – Pyogenic Infections caused by Strep Pyogenes)

1. Impetigo

2. Strep Throat (Pharyngitis)

3. Erysipelas + Celluliis

Hint: Baker 1 Holding

Baker Holding Honey Crusted Pie – Impetigo

Hint: Baker 1

Red Handkerchief – Strep throat (Pharyngitis)

Hint: Baker 1

Red Oven Mittens – Erysipelas, red lesion with well demarcated borders, and Cellulitis

Hint: Baker 2

Baker 2 – Pyogenic Toxins

1. Scarlet Fever

2. Toxic Shock-Like Syndrome

3. Necrotizing Fasciitis

Hint: Baker 2

Strawberry to Tongue – Strawberry Tongue

(Symptom of Scarlet Fever)

Hint: Baker 2

Red Handkerchief – Pharyngitis (Strep Throat)

(Symptom of Scarlet Fever)

Hint: Baker 2 is decorating him

Red Gingerbread Man — Widespread rash that

excludes the face

(Symptom of Scarlet Fever)

Hint: Baker 2’s Cape

Cape w/ Bolt — Toxic Shock-Like Syndrome

(mediated by a superantigen)

(Spe A, Spe C)

Burnt Gingerbread man - Necrotizing Fasciitis

(common to have amputation)

(Spe B)

Hint: “Master Chef” + “Greedy Chef”

“Master Chef” + “Greedy Chef” — Rheumatic Fever (RF) and Post Streptococcal Glomerular Nephritis (PSGN) most common conditions caused by Strep Pyogens

Master Chef — Rheumatic Fever

Greedy Chef — Post Streptococcal Glomerular Nephritis

Master Chef — Rheumatic Fever

(RF is a Type 2 Hypersensitivity Reaction)

Hint: Master Chef

M on the hat — M Protein in group A Strep. Cell Walls

(M Protein = main virulence factor for Rheumatic Fever. Interferes with opsonization, and has anti-phagocytic properties.

M Protein will do molecular mimicry; mimics antibodies in heart —> causes issues with Mitral Valve in heart — Mitral Stenosis)

Hint: Master Chef

Red Handkerchief – Pharyngitis precipitates RF

(Rheumatic Fever starts after Strep Pharyngitis Infections but NOT after Staph skin infections; ex. Impetigo)

Hint: Master Chef

JONES Cupcakes — Symptoms of Rheumatic Fever

1. “J” = Joints (polyarthritis)

2. “Heart” = Heart Problems (Myocarditis, Pericarditis, and Valvular damage —> murmurs)

3. “N” = Subcutaneous Nodules (on forearms, elbows, knees)

4. “E” = Erythema Marginatum (rash w/ thick red boarders)

5. “S” = Sydenham’s Chorea (Rapid movements of hands and face)

Hint: “Greedy Chef”

“Greedy Chef” — Post Streptococcal Glomerular Nephritis

(PSGN is a Type 3 hypersensitivity reaction; deposition of antibody - antigen complex in glomerulus)

Tangled Phone Cord — Looks like a Glomerulus

(Post Strep Glomerulo Nephritis)

Hint: Greedy Chef

Puffy Cheeks – Puffy Cheeks / Facial Swelling from Edema

(common w/ PSGN)

Bottle of Cola – Cola Colored Urine

(common w/ PSGN)

Calendar – PSGN occurs 2 weeks after Strep. infection

Pencil – Antibiotic for Srep. Infections is penicillin

Hint: RF vs. PSGN

RF: Occurs ONLY after Pharyngitis (notice the red handkerchief)

PSGN: Occur after pharyngitis OR impetigo (notice the red handkerchief AND Honey Crusted Crumbs on face)

RF: Early treatment / detection of Strep. WILL prevent RF

PSGN: Early treatment / detection of Strep. will NOT prevent PSGN (!! So even though he has Penicillin, he still has symptoms of PSGN!!)

Hint: Bottom Baker

Baker on bottom — Virulence Factors of Strep. Pyogenes (additional 3)

1. O Shaped Donuts – Streptolysin O, (allows Strep to be Beta Hemolytic. Lysing RBCs. Humans generate ASO antibodies against Streptolysin O)

2. Phosphate Cupcakes – Streptokinase (converts plasminogen to plasmin. Streptokinase can be given as Medication to Lyse blood clots in AMI, Stroke)

3. Twists – DNA’ases (depolymerize DNA)

Basset hound – Bacitracin Sensitive

(The Group A Streps. are sensitive, Group B Streps. are NOT sensitive)

Lady checking a box of donuts – Tongs are antibodies, checking for ASO titers (Antistreptolysin O Titer) to see if there was a Group A Strep Infection

(Commonly done when diagnosing RF or PSGN)