Tuesday, May 15, 2018

Infectious diseases, Part 22: Streptococcal infections

[This entry comes from a section of Chapter 34, "Words about infectious diseases", of Part II of the open-source textbook Spanish-English Cognates: An Unconventional Introduction to Spanish Linguistics.]

As we saw earlier in the chapter, bacteria have traditionally been classified according to their shape (Sp. forma), that is their morphology (Sp. morfología). The two main types are round bacteria and long bacteria, though there are other minor types, such as spiral-shaped, called spirillum (Sp. espirilo), or tightly coiled, spirochaetes (Sp. espiroquetas). Round bacteria are known as cocci (sing. coccus, Sp. coco), from Gk. κόκκος (kókkos) ‘grain, seed’, whereas long bacteria are known as bacilli (sing. bacillus [bə.ˈsɪ.l.əs], Sp. bacilo), from Lat. bacillus, which meant ‘little staff, wand’ and was a diminutive of Latin baculum or baculus ‘walking stick, staff’. As you can see, the names of types of bacteria in English tend to be identical to their New Latin name, whereas Spanish tends to adapt the name to Spanish phonology and orthography (cf. Part I, Chapters 8 and 10).

We have already come across a type of coccus bacterium, namely the staphylococcus (Sp. estafilococo), which causes diseases such as MRSA and staph infections, with pus formation. These bacteria occur in grapelike clusters, hence their name, which comes Greek σταφυλή (staphulḗ) ‘bunch of grapes’. Another type of coccus bacteria is known as streptococcus [ˌstʰɹɛp.tə.ˈkʰɒ.kəs] (Sp. estreptococo), ‘a round to ovoid, gram-positive, often pathogenic’ genus ‘that occurs in pairs or chains’. Many species from this genus ‘destroy red blood cells and cause various diseases in humans, including erysipelas, scarlet fever, and strep throat’ (AHD). The name streptococcus (1877) means something like ‘twisted spherical bacterium’. It is a New Latin name formed from Greek στρεπτός (streptós) ‘twisted’, from the verb στρέφειν (stréphein) ‘to twist’, and the same κόκκος (kókkos) we just saw.

There are more than 50 species of bacteria in the Streptococcus genus, after many that had been classified as Streptococcus were moved to the new genera Enterococcus and Lactococcus. Many species are non-pathogenic, but others are responsible for infections such as streptococcal pharyngitis (strep throat; Sp. faringitis estreptocócica or amigdalitis estreptocócica), many cases of pinkeye (also known as conjunctivitis; Sp. conjuntivitis), meningitis (Sp. meningitis), bacterial pneumonia (Sp. neumonía bacteriana), endocarditis (Sp. endocarditis), erysipelas (Sp. erisipela), and necrotizing fasciitis, ‘flesh-eating’ bacterial infections (see below). It is important to realize that many people who are carriers of the harmful bacteria of this genus are asymptomatic. One may have them in the skin or elsewhere and not show any symptoms.

There are different ways of classifying species of the Streptococcus genus. One common classification method is based on serotypes (Sp. serotipos), that is, one based on antigenic differences in polysaccharides that are located in the bacteria’s cell walls. The Streptococcus serotypes can be divided into more than 20 serologic groups, which are designated by letters: A, B, C, etc.

Streptococcal diseases are classified according to the bacterium group that causes the infection, so they are also designated by letters. The major types of infections are caused by group A and group B Streptococcus bacteria, which is why the two main types of infections are called Group A Streptococcal Infections, also known by the acronym GAS (Sp. estreptococo del grupo A or SGA) and Group B Streptococcal Infections (GBS) (Sp. estreptococo del grupo B or SGB).

Figure 143: Streptococcus pyogenes bacteria.[i]

GAS infections are caused predominantly by Streptococcus pyogenes (Sp. estreptococo beta-hemolítico del grupo A or just estreptococo del grupo A). The main infections are the following:

·   pharyngitis [ˌfæɹ.ɪn.ˈʤ̯.ɾɪs] (Sp. faringitis [fa.ɾiŋ.ˈxi.t̪is]), also known as strep throat in English (see above): it results in inflammation of the pharynx (Sp. faringe), which is ‘the tube that goes from the back of your mouth to the place where the tube divides for food and air’ (DOCE); cf. New Latin (17th century) pharynx, from Ancient Greek φάρυγξ (phárunx) ‘throat’; GAS is the most common bacterial cause of acute pharyngitis: 15-30% of children and 5-10% of adult cases.

·   impetigo [ˌɪm.pɪ.ˈtʰ̯.ɡ̯] (Sp. impetigo [im.ˈpe.t̪i.ɣo]): ‘an acute contagious staphylococcal or streptococcal skin disease characterized by vesicles, pustules, and yellowish crusts’ (MWC); the name comes straight from Lat. impĕtīgo (gen.: impĕtīginis), the Latin name for the disease, which was derived from the verb impĕtĕre ‘to rush upon, assail, attack’; cf. Eng. impetus ~ Sp. ímpetu ‘the force or energy with which a body moves; a driving force’ (COED); impĕtĕre is derived from pĕtĕre ‘ask, beg, request; to seek, aim at, desire’, the source of Sp. pedir ‘ to ask for’; interestingly, impĕtĕre is not related to Eng. impede ~ Sp. impedir (cf. Chapter 25, §25.3.3).

·   pneumonia [nʊ.ˈmoʊ̯.njə] or [nju.ˈmoʊ̯.ni.ə] (Sp. neumonía [neu̯.mo.ˈni.a]):  ‘an acute or chronic disease marked by inflammation of the lungs and caused by viruses, bacteria, or other microorganisms and sometimes by physical and chemical irritants’ (AHD); this comes from the New Latin or Medical Latin term pneumonia ‘inflammation of the lungs’; it comes from Ancient Greek πνευµονία ‘lung disease’, a word derived from πνεύµων (pneúmōn; the regular stem and combining form was πνευµον‑) or πλεύμων (pleúmōn) ‘lung’, plus the suffix ‑ία (-ía), which was added to certain word stems to form feminine abstract nouns.[1]

·   necrotizing fasciitis (Sp. fascitis necrotizante): this is ‘an acute disease in which inflammation of the fasciae of muscles or other organs results in rapid destruction of overlying tissues’ (COED); cf. Eng. necrotize [ˈnɛ.kʰɹ̯.tʰ̯z] and Sp. necrosar(se) ‘to undergo necrosis or cause to necrose’ (AHD), cf. the synonymous English verb necrose ‘to undergo or cause to undergo necrosis’ (AHD); cf. necrosis (Sp. necrosis) ‘death of cells or tissues through injury or disease, especially in a localized area of the body’ (AHD), from Late Latin necrōsis ‘a killing, a causing to die’, from Greek νέκρωσις (nékrōsis) ‘a putting to death, a state of death, mortification’, related to the verb νεκροῦν (nekroun) to kill, mortify’, and to the word νεκρός (nekrós) which as an adjective meant ‘dead’ and as a noun ‘dead body, corpse’; the adjective Eng. necrotic ~ Sp. necrótico/a or necrósico/a has been derived in the modern languages from this New Latin noun.

·    cellulitis [ˌsel.jʊ.ˈlaɪ̯.ɾɪs] (Sp. celulitis [θe.lu.ˈli.t̪is]): ‘inflammation of subcutaneous connective tissue’ (COED); the word was created in 1843 from Latin cellula ‘little chamber’, diminutive of cella ‘storeroom, chamber’, and the suffix ‑itis that means ‘inflammation’ in Medical Latin; cf. patrimonial Sp. celda ‘punishment cell’ and learned célula ‘cell (in biology)’; Eng. cell [ˈsɛɫ] comes from Old French celle


·   streptococcal bacteremia (Sp. bacteriemia estreptococal): bacteremia refers to ‘the presence of bacteria in the blood’; from the root bacteri‑ and the ending ‑emia (or ‑aemia) ‘condition of the blood’, the New Latin combining form of the Ancient Greek word αἷμα (haîma) ‘blood’

·   osteomyelitis (Sp. osteomielitis): ‘a usually bacterial infection of bone and bone marrow in which the resulting inflammation can lead to a reduction of blood supply to the bone’ (AHD); this is a New Latin word formed from Ancient Greek ὀστέον (ostéon) ‘bone’, Ancient Greek μυελός (muelós) ‘marrow’, and the New Latin suffix ‑itis that denotes diseases characterized by inflammation, typically by an infection (from Ancient Greek ‑ῖτις (‑îtis) ‘pertaining to’)

·   otitis media (Sp. otitis media): ‘inflammation of the middle ear, occurring commonly in children as a result of infection and often causing pain and temporary hearing loss’ (AHD); otitis is a late 18th century New Latin word from Greek ὠτ‑ (ōt-), the regular stem of οὖς (oûs) ‘ear’, plus the New (Medical) Latin suffix ‑itis (see above); Greek ος (oûs, ‘ear’ is a cognate of Lat. auris ‘ear’, from an earlier unattested *ausis, and of Old English ēare (English ear) (Sp. oreja ‘ear’ comes from Lat. aurĭcŭla, a diminutive of Lat. auris)

·   sinusitis (Sp. sinusitis): ‘inflammation of the sinuses or a sinus, especially in the nasal region’ (AHD); this is a New Latin word derived from Lat. sinus ‘a hollow, cavity; curve; bosom; etc.’ (cf. patrimonial Sp. seno ‘breast, bosom; womb; cavity, hollow, hole; heart, core; sine (in math)’)

·   meningitis (Sp. meningitis): ‘inflammation of the meninges of the brain and the spinal cord, most often caused by a bacterial or viral infection and characterized by fever, vomiting, intense headache, and stiff neck’ (AHD); this disease may have different causes, cf. §34.3.27 above

Another life-threatening illness in which GAS is involved, by means of the toxins the bacteria produces, is Toxic Shock Syndrome (TSS), which is often fatal (Sp. síndrome del choque tóxico). TSS can also be caused by toxins from Staphylococcus aureus (see §34.3.38). The streptococcal toxic shock syndrome (STSS) is sometimes referred to as toxic shock-like syndrome (TSLS).

The other major type of streptococcal infections are Group B infections, caused by Group B Streptococcus (GBS). These are bacteria found normally in the intestines (gastrointestinal tract), the vagina, and the rectal area. The main infection causing bacterium in this group is Streptococcus agalactiae. The main infections this group causes are postpartum infection and neonatal sepsis. Infections are rare, however, and are almost always associated with underlying abnormalities. In older people, it is associated with congestive heart failure in bedridden patients. Symptoms of GBS infection are:

·    pneumonia (see above)

·   meningitis (see above)

·   bacteremia (see above)

·   skin and soft-tissue infection (SSTI), also known as skin and skin structure infection (SSSI), or acute bacterial skin and skin structure infection (ABSSSI)) (Sp. infección de la piel y de tejidos blandos); they include simple abscesses (Sp. abceso), impetiginous lesions (‘of, relating to, or like impetigo’, WNTIU, see above), furuncles (boils; Sp. furúnculo, divieso), and cellulitis (Sp. celulitis, see above), or more complicated infected ulcers, burns, and major abscesses.

·   pressure ulcers (pressure sores, pressure injuries, bedsores, or decubitus ulcers) (Sp. escara, úlcera de decúbito): ‘an ulceration of the skin and subcutaneous tissue caused by poor circulation due to prolonged pressure on body parts, esp. bony protuberances, occurring in bedridden or immobile patients’ (RHW); the most common name in English for this condition is bedsore [ˈbɛd.ˌsɔɹ] and in Spanish, escara, which is a learned loanword from Lat. eschăra ‘scar, scab’, from Gk. ἐσχάρα (eskhara) ‘earth, brazier; scab caused by a burn, scab’ (Sp. asqueroso ‘disgusting’ seems to come from Vulgar Latin *escharosus ‘full of scabs’ (cf. Lat. Vulgar *ascara, *scara), and the nun asco ‘disgust’ seems to be a back-formation from this adjective, though the fact that it is asco and not ásquero might have been by the influence of an earlier word for this meaning, namely usgo, which was derived from an unattested verbo *osgar ‘to hate’, from a Vulgar Latin *osicare, derived from Lat. ōdisse ‘to hate, detest, dislike’ (cf. Corominas)

·   colonization of diabetic foot infections (Sp. colonización de infections de pie diabético): the term diabetic foot (Sp. pie diabético) refers to a number of pathologies in the foot resulting from diabetes mellitus [daɪ̯.ə.ˈbi.ɾiz mə.ˈlɪ.ɾəs] (Sp. diabetes mellitus) or its complications, such as infection, diabetic foot ulcer, or neuropathic osteoarthropathy; diabetes is ‘a disorder of the metabolism causing excessive thirst and the production of large amounts of urine’ (COED); the name for this disease, Eng. diabetes [ˌdaɪ̯.ə.ˈbi.ɾiz] ~ Sp. diabetes [di̯a.ˈβe.t̪es], is a New Latin word that comes from the διαβήτης (diabḗtēs) ‘passing through’, a participle of the verb διαβαίνω (diabaínō) ‘to pass through’

·   osteomyelitis (Sp. osteomielitis): ‘a usually bacterial infection of bone and bone marrow in which the resulting inflammation can lead to a reduction of blood supply to the bone’ (AHD); such an infection ‘may result in the death of bone tissue’ (MWC); the name of this disease is a New Latin word derived from Ancient Greek ὀστέον (ostéon; root: osté‑) ’bone’, Ancient Greek μυελός (muelós; root muel‑) ‘marrow’ and the adjective-forming suffix -ῖτις (-îtis) which in medicine has come to be used to mean ‘inflammation’.

·   arthritisɹ.ˈθɹ̯.ɾɪs] (Sp. artritis): ‘inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis’ (AHD); the word arthritis is a New Latin word derived from ἄρθρον (árthron) ‘a joint’ and the New Latin suffix ‑itis that means ‘inflammation’

·   discitis or diskitis (Sp. discitis, disquitis): an infection and inflammation of the intervertebral disks cartilage disks separating the spine’s vertebrae; the term is derived from the English word disk or disc (the latter is a Latinate British spelling variant of this word) or its Spanish cognate disco and the suffix ‑itis that in medical language stands for ‘inflammation’; discitis can be caused by viral or bacterial infections as well as by an autoimmune disorder

·   chorioamnionitis or intra-amniotic infection (IAI) (Sp. corioamnionitis, infección intraamniótica, infección ovular, or amnionitis): infection and inflammation of the fetal membranes (inner amnion and outer chorion) and the amniotic fluid; it may happen during vaginal examinations in the last month of pregnancy or during (prolonged) labor. The word chorioamnionitis is a New Latin one derived from the Greek words. The term amnion [ˈæm.nɪ.ən] (Sp. amnios) is the name of ‘the innermost membrane that encloses the embryo of a mammal, bird, or reptile’ (COED); it comes from Lat. amnion ‘membrane around a fetus’, which comes from Gk. ἀμνίον (amnion) ‘bowl in which the blood of victims was caught’. The term chorion ['kɔ.ɹɪ.ǝn] (Sp. corion) refers to ‘the outermost membrane surrounding the embryo of a reptile, bird, or mammal’ (COED) and it comes from Ancient Gk. χόριον (khórion) ‘membrane surrounding the fetus, afterbirth’.

·   endometritis [ˌɛn.doʊ̯.mɪ.ˈtʰɹtraɪ̯.ɾɪs] (Sp. endometritis): inflammation of the endometrium, the inner lining of the uterus, typically caused by bacterial infection; the term endometritis is obviously derived from the term endometrium and the suffix ‑itis. The term endometrium (Sp. endometrio) is a New Latin medical term for the mucous membrane lining the uterus (womb) of mammals. It is formed from the Latin prefix endo‑ ‘inner’ and the Late Latin word for ‘womb’ metrium, which was a loan from Ancient Greek adjective μήτριον (mḗtrion) ‘of a mother’, derived from the noun μήτηρ (mḗtēr) ‘mother’.

·   urinary tract infections (UTI) (Sp. infección urinaria): ‘infection of any part of the urinary tract, esp. the urethra or bladder, usually caused by a bacterium… and often precipitated by increased sexual activity, vaginitis, enlargement of the prostate, or stress’ (RHWU). Many types of bacteria can cause UTIs, including GBS, though most typically it is caused by Escherichia coli.



[1] The original word for ‘lung’ was πλεύμων (pleúmōn), with an λ (l). The variant πνεύµων (pneúmōn) with an ν (n) is thought to have arisen by influence of the verb πνεν (pnéin) ‘to blow’ and the derived noun πνεμα (pneûma) ‘breath’ (cf. Eng. pneumatic ‘containing or operated by air or gas under pressure’, COED; Sp. neumático ‘pneumatic; tire’). Gk. πλεύμων (pleúmōn) is a cognate of Lat. pulmo (pulmōn‑) ‘lung’, source of Sp. pulmón ‘lung’ (cf. Eng. pulmonary).



[i] Photo Credit: Content Providers(s): - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #2110. Public domain: https://commons.wikimedia.org/w/index.php?curid=1164643 (2018.05.14)

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