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Lara gorokan streptokokus: Béda antara owahan

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Wong sing nandhang lara gorokan Streptokokus bakal nuduhake gejala ing sedina nganti telung dina sabanjure senggolan karo wong liya sing ketaman penyakit iki.<ref name=Review09/>
Wong sing nandhang lara gorokan Streptokokus bakal nuduhake gejala ing sedina nganti telung dina sabanjure senggolan karo wong liya sing ketaman penyakit iki.<ref name=Review09/>

{{Image
|title=
|width=190
|height=190
|lines=5
|File:StrepAug2010.JPG|alt1=Sawijining kasus lara gorokan Streptokokus. Deleng amandel sing malih gedhe karo nanah putih.
|File:Streptococcal pharyngitis.jpg|alt2=Kasus lara gorokan Streptokokus. Deleng tutul-tutul abang cilik-cilik. Tutul-tutul abang mengkono ora biyasa kedadeyan nanging minangka gejala kusus.<ref name=Review09/>
|File:Strep throat2010.JPG|alt3=Kasus lara gorokan ing bocah umur 8 taun. Deleng amandel loro sing malih gedhe ing saburine gorokan lang ngemu nanah.
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==Panyebab==
==Panyebab==

Révisi kala 17 Sèptèmber 2013 10.24

Lara gorokan streptokokus
Classification and external resources
ICD-10ICD-10 Chapter J|J020
ICD-9034.0
DiseasesDB12507
MedlinePlus000639
eMedicinemed/1811

Lara gorokan streptokokus yaiku penyakit sing disebabake dening bibit lelara kasebut “gugus bakteri streptokokus A”.[1] Lara gorokan jinis iki namani gorokan, amandel (kelenjar sing cacahe loro wujude lonjong ing gorokan, ing mburi cangkem), lan bisa uga kothak swara (laring). Gejala umum kalebu panas, lara gorokan (uga sinebut pancingen), lan abuhing kelenjar (sinebut kelenjar getah bening) ing gulu. Lara gorokan Streptokokus nyebabake 37 kasus lara gorokan sing kedadeyan marang bocah cilik.[2]

Lara gorokan Streptokokus nyebar lumantar senggolan raket karo panandhang. Supaya 100 persen yakin yen wong ketaman lara gorokan Streptokokus, sawijining tes sinebut kultur gorokan prelu dilakoni. Ewasemono, tanpa tes kasebut, kasus sing memper lara gorokan mengkono bisa ditemtokake saka gejala sing tuwuh. Ing kasus-kasus sing memper utawa wis pesthi, antibiotik (obat sing mbrastha bakteri) bisa nyegah penyakit mundhak parah lan bisa nyepetake kasarasan.[3]

Tandha lan gejala

Gejala umum lelara iki yaiku pancingen, panas luwih saka 38°C (100.4°F), nanah (barang cuwer sing wernane kuning utawa ijo) ing amandel, lan abuhing kelenjar ing gulu.[3]

Kadhangkala tuwuh uga gejala liyane:

  • Sirah ngelu (mumet)[4]
  • Mutah utawa muleg-muleg[4]
  • Lara weteng[4]
  • Awak pating klenyer[5]
  • Bidhuren (kulit pating plenthing abang) ing awak utawa ing njero cangkem utawa gorokan (gejala sing ora lumrah nanging kusus ing jinis lelara iki) [3]

Wong sing nandhang lara gorokan Streptokokus bakal nuduhake gejala ing sedina nganti telung dina sabanjure senggolan karo wong liya sing ketaman penyakit iki.[3]

Panyebab

Lara gorokan Streptokokus disebabake dening bibit lelara (utawa bakteri) sinebutStreptokokus gugus A beta-hemolitik utawa group A beta-hemolytic streptococcus (GAS).[6] Bibit lelara liya uga bisa nyebabake pancingen.[3][5] Lara gorokan Streptokokus nyebar langsung saka senggolan raket karo panandhang. Wong akeh sing nglumpuk dadi siji ing saenggon, kayata ing militer utawa sekolahan, bisa nyepetake sumebaring penyakit ki.[5][7] Bibit penyakit sing wis garing lan tinemu ing lebu ora bisa njalari wong lara. Bibit teles, kaya ta sing tinemu ing sikat untu, bisa marahi wong lara nganti sasuwene 15 dina.[5] Bibit-bibit penyakit iki bisa urip ing pangan senajan arang kedadeyane, lan bisa nyebabake lara marang wong sing mangan pangan mau.[5] Rolas persen bocah sing ora nuduhake gejala lara gorokan iki nggawa bibit GAS ing gorokane.[2]

Nemtokake lara gorokan Streptokokus

Modhifikasi Sekor Centor
Biji Prakira Lara Streptokokus Pangobatan
1 utawa kurang <10% Ora perlu antibiotik utawa kultur
2 11–17% Antibiotik miturut kultur utawa RADT
3 28–35%
4 utawa 5 52% Antibiotik empiris

Saprangkat wewaton sinebut Modhifikasi Sekor Centor digunakake kanggo nemtokake cara nambani wong sing nandhang pancingen. Adhedhasar limang wewaton klinis, sekor Centor nandhani iya orane lara gorokan Streptokokus kedadeyan.[3]

Angka siji dipasangake ing saben wewaton ing ngisor iki:[3]

  • Ora watuk
  • Kelenjar abuh lan empuk ing gulu
  • Suhu badan luwih saka 38°C (100.4°F)
  • Nanahen utawa abuhing kelenjar ing gorokan(amandel)
  • Umur durung nyandhak 15 (angka siji dikurangi tumrap umur luwih saka 44)

Tes laborat

Sawijining tes sinebut kultur gorokan yaiku cara utama[8] kanggo mesthekake iya orane wong nandhang lara gorokan Streptokokus. Kabecikan tes iki nemtokake lelara kasebut kabijen 90 nganti 95 persen saka sakehing wong sing dites.[3] Bisa uga nggunakake sawijining tes sinebut tes kilat Strep (uga sinebut tes kilat dheteksi antigen utawa rapid antigen detection testing/RADT). Tes kilat Strep asile luwih cepet ketemu tinimbang kultur gorokan nanging mung bisa menehi asil becik 70 persen saka sakehing wong sing dites. Tes kaloro mau bisa imbang nemtokake lelara yen panandhang ora kena lara gorokan Streptokokus (yaiku ing 98 persen saka kabehing wong sing dites).[3]

Kultur gorokan positif (liya ukara, sing nemtokake lara oraning wong) utawa tes kilat Strep, ditambah gejala lara gorokan Streptokokus nuduhake tuwuhing lelara kasebut.[9] Wong sing ora nuwuhake gejala ora perlu dites kultur gorokan utawa tes kilat. Gunggung persen tinemtu saka populasi kasebut ngemot bakteri Streptokokus ing gorokan nanging ora nganti mbebayani.[9]

Lelara liyane sing bisa salah diarani lara gorokan Streptokokus

Delengen uga: Acute pharyngitis

Gejala lara gorokan Streptokokus uga bisa kedadeyan ing kahanan lara liyane. Mula, nemtokake lara gorokan Streptokokus bisa angel dilakoni tanpa ngadani tes kultur gorokan utawa tes Streptokokus kilat.[3] Watuk, umbel meler, mencret, lan mripat abang karo perih, saliyane panas lan pancingen biasane luwih memper lara gorokan sing disebabake dening virus tinimbang lara gorokan Streptokokus.[3] Abuhing kelenjar (kelenjar limfe) ing gulu ditambah pancingen, panas, lan kelenjar sing tambah gedhe (amandel) ing gorokan bisa uga tuwuh ing lelara liyane, sinebut mononukleosis infeksiosa.[10]

Panyegahan

Oprasi amandel bisa dadi cara pangobatan kanggo wong sing kerep nandhang lara iki supaya ora tuwuh maneh.[11][12] Nganti taun 2003, yen lara gorokan Streptokokus kedadeyan nganti ping telu luwih ing wektu setahun, oprasi amandel dianggep sing paling trep dilakoni.[13] Ewasemono, nunggu kanthi waspada uga bisa.[11]

Pangobatan

Lara gorokan Streptokokus sing ora diobati biyasane mari ing sauntara dina.[3] Panggunan obat(antibiotik) nyendakake wektu tuwuhing gejala wetarane nganti 16 jam.[3] Pangobatan nganggo antibiotik nduweni tujuan utama yaiku ngurangi risiko lelara sansaya nemen, kayata mundhak panas nemen (sinebut panas rematik) utawa nglumpuking nanah ing gorokan (aran abses retrofaring)[3]. Obat-obat kuwi mau bisa mandi yen diwenehake sajroning wektu 9 dina wiwit gejala tuwuh.[6]

Pangobatan rasa lara

Obat kanggo ngurangi rasa lara, kayata obat sing ngurangi abuh (non-steroidal anti-inflammatory drugs, utawa NSAIDs) utawa obat sing ngudhunake panas (parasetamol, utawa asetaminofen), bisa mbantu ngenthengake rasa lara sing tuwuh bebarengan karo lara gorokan Streptokokus.[14] Steroid bisa uga dianggo [6][15], memper kaya salep utawa balsem sing arane lidocaine.[16] Aspirin bisa dianggo karo wong sing wis dewasa nanging ora prayoga kanggo bocah amarga bisa ningkatake risiko penyakit aran sindrom Reye's sing bisa nyebabake oncating nyawa.[6]

Obat antibiotik

Antibiotik sing umum digunakake ing Amerika kanggo nambani lara gorokan Streptokokus yaiku penisilin V. Obat iki populer amarga aman, regane murah, lan mandi.[3] Obat sing arane amoxicillin luwih disenengi ing wewengkon Eropah.[17] Negara India, sing nduweni risiko luwih dhuwur tumrap tuwuhing panas rematik, milih obat suntik sing arane benzathine penicillin G minangka obat utama sing dianggo.[6] Antibiotik sing bener bisa nyendhakake wektu rata-rata tuwuhing gejala (yaiku telu nganti limang dina) dadi mung sedina. Obat-obatan kuwi mau uga bisa ngurangi sumebaring lelara iki.[9] Utamane kanggo ngurangi komplikasi kayata panas serius, gabagen, utawa infeksi.[18] Linuwihing antibiotik kanggo tamba lara gorokan Streptokokus kudu imbang karo efek samping sing bisa tuwuh sabanjure[5]. Obat antibiotik ora prelu diwenehake marang wong dewasa sing sehat lan nuduhake reaksi negatif marang obat kasebut.[18] Antibiotik kanggo lara gorokan Streptokokus kudu diresepake luwih dhuwur tinimbang prakira parahing kedadeyan lelara iki lan kacepetan sumebare.[19] Obat eritromisin (lan obat-obatan liyane, kaaran macrolides) prayoga kanggo wong sing alergi parah karo penisilin.[3] Sadurunge nganggo penisilin, jinis obat sing arane sefalosporin bisa digunakake kanggo wong sing alergine luwih entheng.[3] Infeksi Streptokokus uga bisa nyebabake abuhing ginjel. Kahanan kaya mengkono tetep bisa tuwuh arepa antibiotik wis dianggo.[6]

Bakale Lelara Iki Sabanjure

Gejala lara gorokan iki biyasane malih apik, ing watara telu nganti limang dina, diobati utawa ora.[9] Pangobatan nganggo antibiotiik ngurangi risiko tuwuhing lelara sing luwih serius lan nyegah sumebaring lelara iki. Bocah bisa langsung mangkat sekolah maneh ing wetara 24 jam sawise ngombe antibiotik.[3]

Kahanan serius ing ngisor iki bisa disebabake dening lara gorokan Streptokokus:

  • Panas nemen, kayata panas rematik[4] utawa scarlet fever[20]
  • Lelara sing bisa marahi nyawa oncat aransindrom syok toksik[20][21]
  • Ginjel abuh[22]
  • Lelara sinebut sindrom PANDAS[22], yaiku masalah imun sing nyebabake gejala patrap sing tuwuhe dumadakan lan kadhangkala serius

Pola lan panyebaran penyakit

Pancingen (utawa faringitis), yaiku sajembaring kategori lelara sing bisa nuwuhake lara gorokan Streptokokus, kadiagnosa ing 11 yuta wong saben tahune ing Amerika Serikat.[3] Sakehing kasus pancingen kasebut biyasane disebabake dening virus. Nanging, bakteri Streptokokus grup A beta-hemolitik nyebabake 15 nganti 30 persen lara pancingen ing bocah lan 5 nganti 20 persen ing wong dewasa.[3] Kasus-kasus kasebut umume kedadeyan ing sarampunge musim dingin lan wiwitane musim semi.[3]

Referensi

  1. ↑ "streptococcal pharyngitis" ing Dorland's Medical Dictionary
  2. ↑ a b Shaikh N, Leonard E, Martin JM (2010). "Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis". Pediatrics. 126 (3): e557–64. doi:10.1542/peds.2009-2648. PMID 20696723. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  3. ↑ a b c d e f g h i j k l m n o p q r s t u Choby BA (2009). "Diagnosis and treatment of streptococcal pharyngitis". Am Fam Physician. 79 (5): 383–90. PMID 19275067. {{cite journal}}: Unknown parameter |month= ignored (pitulung)
  4. ↑ a b c d Brook I, Dohar JE (2006). "Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children". J Fam Pract. 55 (12): S1–11, quiz S12. PMID 17137534. {{cite journal}}: Unknown parameter |month= ignored (pitulung)
  5. ↑ a b c d e f Hayes CS, Williamson H (2001). "Management of Group A beta-hemolytic streptococcal pharyngitis". Am Fam Physician. 63 (8): 1557–64. PMID 11327431. {{cite journal}}: Unknown parameter |month= ignored (pitulung)
  6. ↑ a b c d e f Baltimore RS (2010). "Re-evaluation of antibiotic treatment of streptococcal pharyngitis". Curr. Opin. Pediatr. 22 (1): 77–82. doi:10.1097/MOP.0b013e32833502e7. PMID 19996970. {{cite journal}}: Unknown parameter |month= ignored (pitulung)
  7. ↑ Lindbaek M, Høiby EA, Lermark G, Steinsholt IM, Hjortdahl P (2004). "Predictors for spread of clinical group A streptococcal tonsillitis within the household". Scand J Prim Health Care. 22 (4): 239–43. doi:10.1080/02813430410006729. PMID 15765640.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ↑ Smith, Ellen Reid; Kahan, Scott; Miller, Redonda G. (2008). In A Page Signs & Symptoms. In a Page Series. Hagerstown, Maryland: Lippincott Williams & Wilkins. kc. 312. ISBN 0-7817-7043-2.
  9. ↑ a b c d Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH; Gwaltney (2002). "Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America". Clin. Infect. Dis. 35 (2): 113–25. doi:10.1086/340949. PMID 12087516. {{cite journal}}: Missing |author2= (pitulung); Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  10. ↑ Ebell MH (2004). "Epstein-Barr virus infectious mononucleosis". Am Fam Physician. 70 (7): 1279–87. PMID 15508538.
  11. ↑ a b Paradise JL, Bluestone CD, Bachman RZ; et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. doi:10.1056/NEJM198403153101102. PMID 6700642. {{cite journal}}: Explicit use of et al. in: |author= (pitulung); Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  12. ↑ Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J (2007). "Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial". BMJ. 334 (7600): 939. doi:10.1136/bmj.39140.632604.55. PMC 1865439. PMID 17347187. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  13. ↑ Johnson BC, Alvi A (2003). "Cost-effective workup for tonsillitis. Testing, treatment, and potential complications". Postgrad Med. 113 (3): 115–8, 121. PMID 12647478. {{cite journal}}: Unknown parameter |month= ignored (pitulung)
  14. ↑ Thomas M, Del Mar C, Glasziou P (2000). "How effective are treatments other than antibiotics for acute sore throat?". Br J Gen Pract. 50 (459): 817–20. PMC 1313826. PMID 11127175. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  15. ↑ "Effectiveness of Corticosteroid Treatment in Acute Pharyngitis: A Systematic Review of the Literature". Andrew Wing. 2010; Academic Emergency Medicine.
  16. ↑ "Generic Name: Lidocaine Viscous (Xylocaine Viscous) side effects, medical uses, and drug interactions". MedicineNet.com. Dibukak ing 2010-05-07.
  17. ↑ Bonsignori F, Chiappini E, De Martino M (2010). "The infections of the upper respiratory tract in children". Int J Immunopathol Pharmacol. 23 (1 Suppl): 16–9. PMID 20152073.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  18. ↑ a b Snow V, Mottur-Pilson C, Cooper RJ, Hoffman JR (2001). "Principles of appropriate antibiotic use for acute pharyngitis in adults" (PDF). Ann Intern Med. 134 (6): 506–8. PMID 11255529. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  19. ↑ Linder JA, Bates DW, Lee GM, Finkelstein JA (2005). "Antibiotic treatment of children with sore throat". J Am Med Assoc. 294 (18): 2315–22. doi:10.1001/jama.294.18.2315. PMID 16278359. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  20. ↑ a b "UpToDate Inc".
  21. ↑ Stevens DL, Tanner MH, Winship J; et al. (1989). "Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A". N. Engl. J. Med. 321 (1): 1–7. doi:10.1056/NEJM198907063210101. PMID 2659990. {{cite journal}}: Explicit use of et al. in: |author= (pitulung); Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
  22. ↑ a b Hahn RG, Knox LM, Forman TA (2005). "Evaluation of poststreptococcal illness". Am Fam Physician. 71 (10): 1949–54. PMID 15926411. {{cite journal}}: Unknown parameter |month= ignored (pitulung)CS1 maint: multiple names: authors list (link)
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