Pediatria pre prax 3/2011

Serologic diagnosis of poststreptococcal sequelae in pediatric care

Streptococci are the most prevalent pathogen causing infections of the upper respiratory tract in children. Infections caused by group A Streptococcus pyogenes usually have an uncomplicated course, however are associated with the risk of immunopathological poststreptoccal sequelae (rheumatic fever, reactive arthritis, glomerulonephritis). The demonstration of positive serological tests (ASO, antiDNA-ase B) provides evidence for a recent streptococcal infection and is essential for the correct diagnosis of these complications. Serological test are a reliable, exact and readily available diagnostic method, which however requires a correct interpretation in the context of clinical signs. Increase ASO titers in asymptomatic children are a common problem in paediatric practice. Herein we provide a brief summary of clinical situations in which positive antistreptococcal antibody test are clinically significant.

Keywords: Streptococcus pyogenes, AS0, antiDNA-ase B, rheumatic fever, poststreptococcal glomerulonephritis.