CLIA and Strep throat Questions and Answers

Fusobacterium necrophorum (F-throat)* -demographics -cause -type of bacteria -sx -tx - -MC in college-age kids/adults -potentially fatal if misdiagnosed or untreated -not detected in routine cultures -*Gram neg bacilli* that's part of normal flora -Causes *Lemierre's syndrome* (septic thrombosis in internal jugular vein of neck) -severe sore throat doesn't improve -fever, night sweats, chills -itchy throat -cervical lymphadenopathy -unilateral neck swelling -*RESISTANT to Z-pack* -Tx w/ PCN, clindamycin, or Flagyl 2 tests that are NOT CLIA-waived - -*Microscopic UA* and *wet prep* (KOH or vaginal exam) -anything you have to look in a microscope for -must be performed by provider & are more complex alpha hemolytic vs beta hemolytic - -Alpha - mild, less toxic -Beta - severe, very toxicASO titer & what causes false pos & false neg - -detects prior infection of GABHS, Strep C, or Strep G - measures *level of antistreptolysin O antibodies in blood plasma* -can also indicate a URI, TSS, or scarlet fever -*False neg*: antibiotic use -*False pos*: liver disease, TB, Elevated B-lipoprotein levels CLIA - Clinical Laboratory Improvement Amendments CLIA moderate complexity labs - -more complex tests -requires higher level of operator training/education -audits are *legally required* and are more frequent CLIA-waived - -The Clinical Laboratory Improvement Amendment of 1988 established that some clinical tests be exempted from certain laboratory requirements -*simple tests* -*No legally required audits* -don't have to be a trained lab tech to do them Diphtheria throat - -uncommon acute bacterial infection -gray nastiness in back of throat GABHS - -group A beta hemolytic strep (strep pyogenes) -*gram pos cocci* usually in *chains* -smear on blood agar to classify type of hemolysis -beta = *clear zone of hemolysis*