I try to hit on as many possible types of healthcare topics in these discussions that would appeal to the average American seeking a working knowledge of health knowledge today. Here today I want to help clarify something that I see a lot of patients have a lot of confusion about. And that’s strep. Strep infections in general.
What I present here below will allow you to have a more working knowledge of the term strep when you are talking about infection. People are used to tossing that word about, and I hear a lot of mistakes.
While I touch on some healthcare issues here, the focus of today is more microbiology and nomenclature with regards to the term strep. So the disclaimer here might be, leave the deep thinking to the microbiologist or infectious disease specialist.
You’ve heard people say
“I have strep throat”
“She had a strep pneumonia”
“My doctor said strep grew out of my throat culture, but he said I don’t have step throat”
“My OB said my baby got a strep infection at birth, but it’s not the same as strep throat”
“I thought toxic shock was staph, but my doctor said it was a strep type of toxic shock”
No two of those streps are the same thing!
All of this confusion will be resolved by the time you hit conclusion below.
When we classify living things, everything has a genus and species. The same works for bacteria. And there is a very large genus of bacteria called strep. That’s short for Streptococcus.
Many types of strep colonize (B, D…), but don’t infect. Colonizing means they just live there, they hang out there, but they don’t produce a disease state nor hurt you by just hanging out there.
So, strep B, strep D, like that, can grow in many body tissues without being harmful to you. So, as long as these are not pathogens, your doctor will tell you, a form of strep grew out in your throat or some other body part (lungs from a deep aspirate culture, rectum, vagina, bladder, or wherever), but it was a contaminant, or something just growing there that is not causing you problems. And lab will tell your doctor she has nothing to worry about in that particular patient.
So now I’m going to turn to the types of streptococcus that DO cause infection.
Four types of strep are the most common types of streptococcus lead to actual infection.
Strep throat (A beta hemolytic strep)
Group B strep (babies get this from mom’s vagina)
Strep pneumo (s. pneumonia, most infectious diseases including cellulitis or skin infection)
Toxic shock strep (strep pyogenes)
Strep A and Scarlett Fever
The type of strep that causes strep throat is the one that makes the body produce antibodies against your heart and skin and kidneys and produces conditions called rheumatic fever and scarlet fever, not to mention a kidney disease called glomerulonephritis that can lead to renal failure. It’s the one you were spanking you for because it happened would missing. It’s common. It has many side effects. Looks like a virus, but this pharyngitis is the one you must treat with antibiotics. Can’t miss it. That mistake could be lethal.
Strep Group B
Group B strep or GBS is a strep totally different from strep throat that hangs out in the vagina and infects babies during delivery. That could put a baby in the ICU for months. Very dangerous infection in the world of OB/GYN. OBs will refer to it as strep, and that confuses people. It is not strep throat. It is group B strep.
Toxic Shock Syndrome
Toxic Shock Syndrome is famous for causing very sick women and it’s famously associated with a retained tampon. Other causes as well. But… The most common form of it his staph. Staff aureus that is. But another common form of it is also strep. And this strep is not group B strep. And it’s not strep throat. It’s strep pyogenes.
Strep Pneumoniae or Strep Pneumonia
Lastly, the most common form of any type of strep infection is called strep pneumoniae or strep pneumonia. As its name implies, it produces pneumonia. Community acquired pneumonia, so there pneumonia we see in healthy people. But, even though many oppportunistic odd bugs cause pneumonia and infection in the immune compromised folk, strep is still the most common cause of pneumonia in immunity compromised people (AIDS, the elderly, newborn babies, including premies) as well. Strep pneumonia. Not strep throat, not GBS, not strep pyogenes. But yes the biggest cause of all strep infections across the board, whether you are healthy or immunocompromised.
So there are streptococci that colonize. And there are streptococci that infect and cause disease. There are four main disease causing pathogens. Yes there are others that cause infection. But if you remember these four, A beta strep – the strep throat that can cause heart and kidney problems including scarlet fever and rheumatic fever, group B strep that causes OB/GYN infections, strep pyogenes which causes the “other” type of toxic shock syndrome that isn’t staph, and strep pneumo that causes pretty much all other infections caused by strep organisms including pneumonia and cellulitis, just those four… If you remember these… Well, then you are at least keeping up with your doctor.