title: [Two cases of severe community-acquired pleural pneumonia due to Streptococcus pyogenes].
abstract: BACKGROUND
  The microorganisms incriminated in severe community-acquired pneumonia hospitalized in intensive care unit are the following: Streptococcus pneumoniae, enterobacteria isolated in aspiration-related pneumonia and less frequently intracellular bacteria in so-called atypical pneumonia (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila).
  
  
  METHODS
  We report two cases of severe community-acquired pneumonia admitted in intensive care unit and due to Lancefield Group A beta hemolytic streptococcus (Streptococcus pyogenes). Despite the increased incidence of invasive streptococcal infections, this microorganism still has a rare causative role in the pathogenesis of community-acquired pneumonia. The case reports concern two young patients without any significant medical history and with many clinical, radiological and microbiological similarities. However, the prognosis was not the same because of the way the initial management has been provided.
  
  
  CONCLUSIONS
  Group A beta hemolytic streptococcus could be a causative microorganism of severe and possibly fulminating community-acquired pneumonia, even in young and healthy patients as is the case with pneumococcal infections. Medical history, clinical symptoms and radiological signs should be taken into account to evoke the diagnosis and to initiate antibiotherapy early, taking into account that this microorganism is sensitive to Penicillin G.
authors.affiliation: Service de Réanimation polyvalente, CH Sud Francilien, Hôpital Gilles de Corbeil, Corbeil essonnes.
authors.forename: Florence
authors.initials: F
authors.lastname: Gantier
authors.forename: Thierry
authors.initials: T
authors.lastname: Lherm
authors.forename: Bruno
authors.initials: B
authors.lastname: Nougiere
authors.forename: Daho
authors.initials: D
authors.lastname: Larbi
authors.forename: Christian
authors.initials: C
authors.lastname: Legall
authors.forename: Claire
authors.initials: C
authors.lastname: Malbrunot
authors.forename: Daniel
authors.initials: D
authors.lastname: Caen
mesh_terms: D015746:Abdominal Pain / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003422:Critical Care / Q000379:methods; D004351:Drug Resistance; D004417:Dyspnea / Q000382:microbiology; D005334:Fever / Q000382:microbiology; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008826:Microbial Sensitivity Tests; D010808:Physical Examination; D018410:Pneumonia, Bacterial / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D011379:Prognosis; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents