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Group A β-Hemolytic Streptococci as a Cause of Bacteremia in Children

Group A β-Hemolytic Streptococci as a Cause of Bacteremia in Children Abstract • The clinical manifestations of patients with group A β-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed. Group A β-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period. Systemic Illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients). Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients). The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient). Two patients died of apparent overwhelming GAS sepsis while at home. Group A β hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease In children. (AJDC 1988;142:831-833) References 1. Lancefield RC: A serologic differentiation of human and other groups of hemolytic streptococci . J Exp Med 1933;57:571-595.Crossref 2. Bibler MR, Rouan GW: Cryptogenic group A streptococcal bacteremia: Experience at an urban general hospital and review of the literature . Rev Infect Dis 1986;8:941-951.Crossref 3. Hable KA, Herstmeier C, Wold AD, et al: Group A beta hemolytic streptococcemia: Bacteriologic and clinical study of 44 cases . Mayo Clin Proc 1973;48:336-339. 4. Keefer CS, Ingelfinger FJ, Spink WW: Significance of hemolytic streptococci bacteremia: A study of 246 patients . Arch Intern Med 1937;60:1084-1097.Crossref 5. Madsen ST: Scarlet fever and erysipelas in Norway during the last 100 years . Infection 1973;1:76-81.Crossref 6. Quinn RW: Epidemiology of group A streptococcal infections: Their changing frequency and severity . Yale J Biol Med 1982;55:265-270. 7. DiSciascio G, Taranta A: Rheumatic fever in children . Am Heart J 1980;99:635-658.Crossref 8. Veasy LG, Wiedmeier SE, Orsmono GS, et al: Resurgence of acute rheumatic fever in the intermountain area of the United States . N Engl J Med 1987;316:421-427.Crossref 9. Congeni B, Rizzo C, Congeni J, et al: Outbreak of acute rheumatic fever in northeast Ohio . J Pediatr 1987;111:176-179.Crossref 10. Hosier DM, Craenen JM, Teske DW, et al: Resurgence of acute rheumatic fever . AJDC 1987;141:730-733. 11. Quintiliani R, Engh GA: Overwhelming sepsis associated with group A beta hemolytic streptococci . J Bone Joint Surg Am 1971;53:1391-1399. 12. Barg NL, Kish MA, Kaufman CA, et al: Group A streptococcal bacteremia in intravenous drug abusers . Am J Med 1985;78:569-574.Crossref 13. Duma RJ, Weinberg AN, Medrek TF, et al: Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia . Medicine 1969;48:87-127.Crossref 14. Bullowa JGM, Wishik SM: Complications of varicella: Their occurrence in 2534 patients . AJDC 1935;49:923-926. 15. Mallory GK, Keefer CS: Tissue reaction in fatal cases of Streptococcus hemolyticus infection . Arch Pathol Lab Med 1941;32:334-335. 16. Peter G, Smith AL: Group A streptococcal infections of the skin and pharynx . N Engl J Med 1977;297:365-370.Crossref 17. Barnham M: Bacteremia in streptococcal infections of the throat . J Infect 1983;7:203-209.Crossref 18. Dudding B, Humphrey GB, Nesbit ME: Beta hemolytic streptococcal septicemias in childhood leukemias . Pediatrics 1969;43:359-364. 19. Mogabgab WJ, Thomas L: The effect of cortisone on bacterial infection: Group A hemolytic streptococcal infection in rabbits . JLab Clin Med 1952;39:271-289. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Group A β-Hemolytic Streptococci as a Cause of Bacteremia in Children

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1988.02150080037016
Publisher site
See Article on Publisher Site

Abstract

Abstract • The clinical manifestations of patients with group A β-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed. Group A β-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period. Systemic Illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients). Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients). The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient). Two patients died of apparent overwhelming GAS sepsis while at home. Group A β hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease In children. (AJDC 1988;142:831-833) References 1. Lancefield RC: A serologic differentiation of human and other groups of hemolytic streptococci . J Exp Med 1933;57:571-595.Crossref 2. Bibler MR, Rouan GW: Cryptogenic group A streptococcal bacteremia: Experience at an urban general hospital and review of the literature . Rev Infect Dis 1986;8:941-951.Crossref 3. Hable KA, Herstmeier C, Wold AD, et al: Group A beta hemolytic streptococcemia: Bacteriologic and clinical study of 44 cases . Mayo Clin Proc 1973;48:336-339. 4. Keefer CS, Ingelfinger FJ, Spink WW: Significance of hemolytic streptococci bacteremia: A study of 246 patients . Arch Intern Med 1937;60:1084-1097.Crossref 5. Madsen ST: Scarlet fever and erysipelas in Norway during the last 100 years . Infection 1973;1:76-81.Crossref 6. Quinn RW: Epidemiology of group A streptococcal infections: Their changing frequency and severity . Yale J Biol Med 1982;55:265-270. 7. DiSciascio G, Taranta A: Rheumatic fever in children . Am Heart J 1980;99:635-658.Crossref 8. Veasy LG, Wiedmeier SE, Orsmono GS, et al: Resurgence of acute rheumatic fever in the intermountain area of the United States . N Engl J Med 1987;316:421-427.Crossref 9. Congeni B, Rizzo C, Congeni J, et al: Outbreak of acute rheumatic fever in northeast Ohio . J Pediatr 1987;111:176-179.Crossref 10. Hosier DM, Craenen JM, Teske DW, et al: Resurgence of acute rheumatic fever . AJDC 1987;141:730-733. 11. Quintiliani R, Engh GA: Overwhelming sepsis associated with group A beta hemolytic streptococci . J Bone Joint Surg Am 1971;53:1391-1399. 12. Barg NL, Kish MA, Kaufman CA, et al: Group A streptococcal bacteremia in intravenous drug abusers . Am J Med 1985;78:569-574.Crossref 13. Duma RJ, Weinberg AN, Medrek TF, et al: Streptococcal infections: A bacteriologic and clinical study of streptococcal bacteremia . Medicine 1969;48:87-127.Crossref 14. Bullowa JGM, Wishik SM: Complications of varicella: Their occurrence in 2534 patients . AJDC 1935;49:923-926. 15. Mallory GK, Keefer CS: Tissue reaction in fatal cases of Streptococcus hemolyticus infection . Arch Pathol Lab Med 1941;32:334-335. 16. Peter G, Smith AL: Group A streptococcal infections of the skin and pharynx . N Engl J Med 1977;297:365-370.Crossref 17. Barnham M: Bacteremia in streptococcal infections of the throat . J Infect 1983;7:203-209.Crossref 18. Dudding B, Humphrey GB, Nesbit ME: Beta hemolytic streptococcal septicemias in childhood leukemias . Pediatrics 1969;43:359-364. 19. Mogabgab WJ, Thomas L: The effect of cortisone on bacterial infection: Group A hemolytic streptococcal infection in rabbits . JLab Clin Med 1952;39:271-289.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Aug 1, 1988

References