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Strep Infection: Invasive Group A β-Hemolytic Streptococcus, Pediatric

Maribeth Chitkara, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Infection associated with isolation of group A β-hemolytic streptococci (GABHS) from a normally sterile body site; includes three clinical syndromes: 
  • GABHS toxic shock syndrome (STSS...

DIAGNOSIS

HISTORY

  • Historic features vary depending on the GABHS syndrome.

  • Typically presents with fever and the abrupt onset of severe pain

  • May have preceding soft tissue infection such as cellulitis

  • A pr...

TREATMENT

GENERAL MEASURES

  • Volume resuscitation

  • Anticipatory management of multisystem organ failure

  • Replete electrolytes as indicated

  • Inotropes as indicated

  • Blood products as indicated for anemia or throm...

ONGOING CARE

PROGNOSIS

  • Fulminant course with rapid deterioration is characteristic of invasive GABHS infections.

  • Prognosis is improved with early recognition and aggressive management.

  • Case fatality rate...

ADDITIONAL READING

  • American Academy of Pediatrics. Group A streptococcal infections. In: Kimberlin DW, Brady MT, Jackson MA, et al, eds. Red Book: 2015 Report of the Committee on Infectious Diseases. ...

CODES

ICD9

  • 041.01 Streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group A

  • 041.02 Streptococcus infection in conditions classified elsewhere and of unsp...

FAQ

  • Q: For whom should the diagnosis of invasive GABHS be entertained?

  • A: Consider GABHS in any child with varicella who experiences recrudescence of fever, fever ≥39°C (102.2°F) beyond the 3rd day of ...

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