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Learning objectives

  • Identify the most common bacteria that can cause infections of the upper and lower respiratory tract
  • Compare the major characteristics of specific bacterial diseases of the respiratory tract

The respiratory tract can be infected by a variety of bacteria, both gram positive and gram negative. Although the diseases that they cause may range from mild to severe, in most cases, the microbes remain localized within the respiratory system. Fortunately, most of these infections also respond well to antibiotic therapy.

Streptococcal infections

A common upper respiratory infection, streptococcal pharyngitis ( strep throat ) is caused by Streptococcus pyogenes . This gram-positive bacterium appears as chains of cocci, as seen in [link] . Rebecca Lancefield serologically classified streptococci in the 1930s using carbohydrate antigens from the bacterial cell walls. S. pyogenes is the sole member of the Lancefield group A streptococci and is often referred to as GAS, or group A strep.

Micrograph of chains of spheres.
This scanning electron micrograph of Streptococcus pyogenes shows the characteristic cellular phenotype resembling chains of cocci. (credit: modification of work by U.S. Centers for Disease Control and Prevention - Medical Illustrator)

Similar to streptococcal infections of the skin, the mucosal membranes of the pharynx are damaged by the release of a variety of exoenzymes and exotoxins by this extracellular pathogen. Many strains of S. pyogenes can degrade connective tissues by using hyaluronidase , collagenase and streptokinase . Streptokinase activates plasmin, which leads to degradation of fibrin and, in turn, dissolution of blood clots, which assists in the spread of the pathogen. Released toxins include streptolysin s that can destroy red and white blood cells. The classic signs of streptococcal pharyngitis are a fever higher than 38 °C (100.4 °F); intense pharyngeal pain; erythema associated with pharyngeal inflammation; and swollen, dark-red palatine tonsils, often dotted with patches of pus; and petechiae (microcapillary hemorrhages) on the soft or hard palate (roof of the mouth) ( [link] ). The submandibular lymph nodes beneath the angle of the jaw are also often swollen during strep throat.

Some strains of group A streptococci produce erythrogenic toxin . This exotoxin is encoded by a temperate bacteriophage (bacterial virus) and is an example of phage conversion (see The Viral Life Cycle ). The toxin attacks the plasma membranes of capillary endothelial cells and leads to scarlet fever (or scarlatina), a disseminated fine red rash on the skin, and strawberry tongue , a red rash on the tongue ( [link] ). Severe cases may even lead to streptococcal toxic shock syndrome (STSS) , which results from massive superantigen production that leads to septic shock and death.

S. pyogenes can be easily spread by direct contact or droplet transmission through coughing and sneezing. The disease can be diagnosed quickly using a rapid enzyme immunoassay for the group A antigen. However, due to a significant rate of false-negative results (up to 30% WL Lean et al. “Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-Analysis.” Pediatrics 134, no. 4 (2014):771–781. ), culture identification is still the gold standard to confirm pharyngitis due to S. pyogenes . S. pyogenes can be identified as a catalase-negative, beta hemolytic bacterium that is susceptible to 0.04 units of bacitracin. Antibiotic resistance is limited for this bacterium, so most β-lactams remain effective; oral amoxicillin and intramuscular penicillin G are those most commonly prescribed.

Questions & Answers

Hi, I'm new here. I'm Bello Abdul Hakeem from Nigeria.
BELLO Reply
welcome on board
Kamaluddeen
Thanks brother I'm an undergraduate. I hope to study for MBBS.
BELLO
pls guys help me out
Linda
what is limitation of plate
Linda
limitation of plate load test . there are some that should be considered while performing load test which are given below, this test is usually performed on relatively similar plate ,usually 1 or 2 square foot area the reason is that the plate of greater are the economically not feasible
yemi
Mechanism of bacterial pathogenicity
rashida Reply
Toxicity
Ibrahim
write a short note on Algea
najaatu Reply
green minutes plants organisms that are produced in turf.
Prince
Algae is a kind of a photosynthetic organism, which is usually grown in the moist areas. These are usually the simple plants that grow near to the water bodies. It contains a kind of chlorophyll pigments that act as a primary coloring agent.
Avi
they are eukaryotic and most lived in fresh water. they are photosynthetic that's, they contain chlorophyll and store starch in discrete chloroplast.
Prince
are bacteria important to man
just Reply
yes, depending on the type of bacteria .eg the normal florals, the latic acid batteries etc are important to man
Lois
I mean latic acid bacterial
Lois
I don't understand this topic
Jane Reply
what topic is that
Rose
sahi kon hai bhosri ke
saurabh Reply
define metabolism of carbohydrates with example
Thavasi Reply
what is sterilization a
Sani
the process of keep equipment free from bacteria
shar
is it only bacteria?
Lois
no undesirable fungi and contamination also.
Khushbu
what is streak plate method
Offikwu
what is the biofilm
Dimingu
metabolism is the sum of all the biochemical reaction required for energy generation and use of that energy to synthesize cell materials from small molecules in environment.
Alex
boclenia
Pooja
what are granulocytes
Shawnitta Reply
e.coli
Sukhdeep
granulocytes are type of WBCs which contains granules in the cytoplasm
Owili
suitable example for prokaryotes
Suvetha Reply
one of the possible early sources of energy was
Suvetha
uv radiation and lighting
Anisha
e coli is the example of prokaryotes
Sukhdeep
archaea too
Noel
which is the specific virus causing typhoid
Jeremiah Reply
it's caused by a virulent bacteria called Salmonella Typhi
Sarah
write the life cycle of HIV
Firomsa Reply
describe the internal and external structure of prokaryotic cell in terms of there appearance and functions
Lenia Reply
compare and contrast similar structures found in prokaryotic and eukaryotic cells
Lenia
control of microorganisms
ISTEFAZUL Reply
what is sterilization
Sani
how can a doctor treat a person affected by endospore forming bacteria in his/her wound?
Mambo Reply
define disinfectant
Sani
the process of killing
shar
the process of killing microorganisms
shar
a 28 years old woman come to your clinic with complain of fever painful genital blisters which express clear fluid when ruptured burning sensation around the bristers what is the diagnosis?
Ramadhani Reply
genital herpes caused by a virus called herpe simplex virus
Doris

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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