Bacteremia with group A streptococci in childhood
C. D. Christie, P. L. Havens and E. D. Shapiro
Department of Pediatrics, Yale University School of Medicine, New Haven, Conn.
Medical records of 60 patients with bacteremia caused by group A
streptococci who were treated at the Yale-New Haven (Conn) Hospital from
1973 to 1986 and the Boston Children's Hospital Medical Center from 1977 to
1984 were reviewed. Seven children (12%) were immunocompromised, seven
(12%) had varicella, and two (3%) had cavernous hemangiomas. Fifty-two
children (87%) had an identifiable focus of infection. The most commonly
documented sources of bacteremia were in the skin (22 children) and the
respiratory tract (19 children). Metastatic foci of infection included
osteomyelitis (nine children), septic arthritis (eight children), and
meningitis (three children). Seven episodes were nosocomial (four were
catheter related and three occurred postoperatively). Four patients (7%)
died: two were severely immunocompromised, one of whom had extensive
hemorrhagic varicella; the third had widespread hemorrhage into a large
cavernous hemangioma of the skin; the fourth had an initial diagnosis of
sudden infant death syndrome. Bacteremia with group A streptococci,
although uncommon, continues to cause serious infections in children during
the antibiotic era.
