title: Emergence of invasive group A streptococcal disease among young children.
abstract: Eight cases of invasive group A streptococcal disease in young children were reported over a three-month period, February to April 1990. The spectrum of clinical disease included: pneumonia with bacteremia (two patients), osteomyelitis/septic arthritis (three patients), epiglottitis/supraglottitis (two patients), and sepsis without a focus (one patient). Three cases followed chicken pox. Three children were in shock at the time of presentation, including one child who had a toxic shock-like appearance. Only four children had pharyngitis. Bacteremia was confirmed in three children and presumed in another three. All the subjects survived. Four isolates of group A streptococci were tested for exotoxin A, B, and C (A-0, B-4, C-1) production. These data confirm the reappearance of a highly invasive strain of group A streptococci capable of producing a variety of clinical diseases, including bacteremia and shock, in a significant proportion of victims.
authors.affiliation: Department of Pediatrics, State University of New York, School of Medicine, Buffalo.
authors.forename: W
authors.initials: W
authors.lastname: Novotny
authors.forename: H
authors.initials: H
authors.lastname: Faden
authors.forename: L
authors.initials: L
authors.lastname: Mosovich
mesh_terms: D000293:Adolescent; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000209:etiology; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology; D015984:Causality; D002481:Cellulitis / Q000453:epidemiology / Q000209:etiology; D002644:Chickenpox / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D008297:Male; D009518:New York / Q000453:epidemiology; D010019:Osteomyelitis / Q000453:epidemiology / Q000209:etiology; D010612:Pharyngitis / Q000453:epidemiology / Q000209:etiology; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D012703:Serotyping; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes