Varied presentations of sporadic group A streptococcal bacteremia: clinical experience and attempt at classification.
The epidemiologic, clinical, and laboratory aspects of group A streptococcal bacteremia were studied in 33 patients seen at two urban hospitals in the Tel Aviv (Israel) area, over an 8-year period. Most patients (two-thirds) were female. Clinically significant bacteremia was observed in 26 patients, two of whom acquired their infection (puerperal sepsis) during hospitalization. A portal of entry, mainly cutaneous, was recognized in 61% of the patients, and a chronic underlying condition was observed in 69%. The case-fatality rate was 27%, with death occurring predominantly in patients admitted with shock or cryptogenic bacteremia. Our clinical experience and literature review show that the presentation of group A streptococcal bacteremia is diverse, with transient bacteremia of uncertain clinical significance on one end of the spectrum and overwhelming sepsis on the other. A practical classification of the various clinical forms of group A streptococcal bacteremia is proposed.
Department of Medicine E, E. Wolfson Hospital, Holon, Israel.
M
M
Dan
S
S
Maximova
Y
Y
Siegman-Igra
R
R
Gutman
H H
HH
Rotmensch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000145:classification* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D013290:Streptococcal Infections / Q000145:classification* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D013297:Streptococcus pyogenes