GABHS v. GAS?

[LNN]

For those geekier than I am, can someone explain the difference between GABHS and GAS? I sometimes see them used interchangeably. I know GABHS is Group A Beta Hemolytic Strep and GAS is Group A strep.

 

Is GABHS specifically "strep thoat" and GAS is any other kind of Group A strep infection?

 

And why did Swedo zero in on GABHS specifically? Several strains of strep can cause pharyngitis/strep throat.

 

Can someone shed some light?

[sf_mom]

They are the same thing. GAS is slang (Group A Strep = GAS). There are many strains of GABHS and can cause the following.

 

Strep throat, acute otitis media, scarlet fever, impetigo, sinusitis, pneumonia or cellulitis (infection of the deep layers of the skin). Invasive, toxigenic infections can result in necrotizing fasciitis, myositis and streptococcal toxic shock syndrome. Patients may also develop immune-mediated post-streptococcal sequelae, such as acute rheumatic fever, acute glomerulonephritis and SC.

 

Hopefully, that helps.

[LNN]

Then why the insistence by some docs that there has to be a positive throat culture to even entertain a Pandas dx? Somewhere, this dismissal of other sources of infection came into play. What makes strep throat such an important criteria? You even see it in the recent articles (e.g. Can Strep Throat Trigger OCD?" The emphasis is always on the throat.

[sf_mom]

I am very confused by that issue too and also by lack of ASO and Anti-DNase-B Titers ruling out strep infections.

 

Its crazy but it will all get resolved in the next 10 years and unfortunately too late as a determinate for our kids. I forgot to add that the more resilient strains create a 'white puss'... in ear, back of throat, etc.

 

-Wendy

 

 

 

 

Then why the insistence by some docs that there has to be a positive throat culture to even entertain a Pandas dx? Somewhere, this dismissal of other sources of infection came into play. What makes strep throat such an important criteria? You even see it in the recent articles (e.g. Can Strep Throat Trigger OCD?" The emphasis is always on the throat.

[Buster]

Then why the insistence by some docs that there has to be a positive throat culture to even entertain a Pandas dx? Somewhere, this dismissal of other sources of infection came into play. What makes strep throat such an important criteria? You even see it in the recent articles (e.g. Can Strep Throat Trigger OCD?" The emphasis is always on the throat.

 

This is due to the work of Kurlan and Kaplan where they published in Pediatrics 2008 the separation of "definite", "probable" and "possible" GABHS infections and told folks that "definite" in their study was

• a positive throat culture
  
• clinical symptoms
  
• and a rise in ASO titers in 1-3 weeks post positive culture
  

They chose this extremely limited definition so that no one could argue whether there was or was not a strep infection. Unfortunately, this caused some pediatricians to think this is required rather than the particular choice of that research group. In addition, they chose their kids from children with 3 years + of tic symptoms with no remission. Their purpose (based on sample selection) appears to be to prove that Tourette's kids matching the definition of PANDAS who have symptoms long enough don't have exacerbations cotemporal with GABHS infections. Strangely that isn't what they showed, but the paper is terrible in revealing both the flaw in the paper and the fact that they did find that kids matching the PANDAS subgroup (even from the Tourette's subjects) got more GABHS infections. Sigh

 

Buster

[Buster]

For those geekier than I am, can someone explain the difference between GABHS and GAS? I sometimes see them used interchangeably. I know GABHS is Group A Beta Hemolytic Strep and GAS is Group A strep.

 

Is GABHS specifically "strep thoat" and GAS is any other kind of Group A strep infection?

 

And why did Swedo zero in on GABHS specifically? Several strains of strep can cause pharyngitis/strep throat.

 

Can someone shed some light?

Oh, on the geeky side, Group A strep is almost alway Beta-Hemolytic (meaning it creates completely lyses the cells). Group B can be alpha or gamma hemolytic. This is why GAS and GABHS are used interchangably.

[sf_mom]

Buster... You definitely explained it much better than me. Thanks!