Transcription of 小児科からみた A 群β 溶血性レンサ球菌による咽頭扁桃炎
1 A A A 1998 A A A V I, J A A (group A -hemolytic streptococcus: GABHS) Streptococcus pyogenes GABHS GABHS 1970 1 5 GABHS A I.
2 1. 2. 3. 4. A II. 1. 2. 3. A 1. GABHS 5 10% 15 30% 1) 3 15 2 5 24 24 4 7 GABHS GABHS GABHS GABHS GABHS GABHS GABHS streptococcal pyrogenic exotoxin-A.
3 C Dick GABHS EB A C G F 2. GABHS 10% GABHS 6 GABHS GABHS GABHS CRP 1 2 3
4 EB (EBV: Epstein-Barr Virus) EBV VCA VCA-IgG EBV EBNA EBNA VCA VCA-IgM GABHS 2) GABHS PFAPA periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome 3) PFAPA 4 5 4 5 5 A 1.
5 A GABHS GABHS 32 25% GABHS 50% 4) Streptococcus dysgalactiae subsp. equisimilis (group G) Streptococcus constellatus subsp. constellatus (group F) 1 C G F GABHS GABHS 5 10 GABHS 24 2.
6 GABHS 6 GABHS 10 2 43 90% A 3 6 3 1 3 10 2 3 19 2 5 ) 3 7 ) (5 15 ) M 49, 2, 55, 56, 57, 59, 60, 61 12, 1, 4, 25 1, 3, 5, 6, 14, 18, 19, 24 III II, IV CRP A 1.
7 (minimum inhibitory concentration MIC) 1990 1970 5) 6) recurrence relapse GABHS re-infection GABHS M 150 1 10 M GABHS M GABHS 7) GABHS PrtF1, Fbp54, SOF/SfbII 8) GABHS 9) GABHS 1 10 20% 10) 11) M GABHS GABHS GABHS GABHS 12) 13) 14) 15) GABHS 12)
8 GABHS 16) GABHS GABHS 17) 2. 1 90%18) 2 70% 19) 5 14 20) GABHS GABHS 5 14 GABHS A 1.
9 2. GABHS 2 20)-22) 1 2 15 GABHS 10 20 9) 3. 35 10 10 20) 22) 10 14 5 5 10 22 5 10 23) 24) 12)
10 5 25) 5 3 3 MIC 3 1 26) 5 66% 33% 93% 10 4. GABHS GABHS 1 2 10 10 2 18) 27) 1 3 10 1 10 10 18) 1 3 7 10 2 10 10 27)
