A child had pustular lesion on leg. On grainstaining gram positive cocci are seen. To establish the diagnosis of Group A streptococcal erythroderma, the test used is
**Core Concept**
The question is testing the student's knowledge of a specific diagnostic test used to identify Group A streptococcal infections, which are often associated with skin manifestations such as erythroderma. The correct answer involves a test that can distinguish Group A streptococci from other gram-positive cocci.
**Why the Correct Answer is Right**
To establish the diagnosis of Group A streptococcal erythroderma, the CAMP (Christie-Atkins-Munch-Peterson) test is used. This test involves incubating the patient's skin lesion with a strain of Staphylococcus aureus, which produces staphylococcal hemolysin. If the patient's lesion contains Group A streptococci, the staphylococcal hemolysin will enhance the hemolysis of the sheep blood agar, creating a characteristic double zone of hemolysis. This reaction is specific for Group A streptococci and is used to differentiate them from other gram-positive cocci, such as Staphylococcus aureus or other beta-hemolytic streptococci.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is likely incorrect as it does not specify a test used to identify Group A streptococci. While there are several tests used to diagnose streptococcal infections, such as the rapid streptococcal antigen test or the throat culture, none of these tests are specifically used to identify Group A streptococcal erythroderma.
**Option B:** This option is also incorrect as it does not mention the CAMP test, which is the correct test used to identify Group A streptococcal erythroderma.
**Option D:** This option is likely incorrect as it does not specify a test used to identify Group A streptococci. While there are several tests used to diagnose streptococcal infections, such as the rapid streptococcal antigen test or the throat culture, none of these tests are specifically used to identify Group A streptococcal erythroderma.
**Clinical Pearl / High-Yield Fact**
The CAMP test is a specific diagnostic test used to identify Group A streptococcal infections, which can present with a range of skin manifestations, including erythroderma. This test is particularly useful in differentiating Group A streptococci from other gram-positive cocci, which can present with similar clinical features.
**Correct Answer: C. CAMP test**