Group A beta-hemolytic streptococci as a cause of bacteremia in children
V. K. Wong and H. T. Wright Jr
Department of Pediatrics, Children's Hospital, Los Angeles.
The clinical manifestations of patients with group A beta-hemolytic
streptococcal (GAS) bacteremia presenting to an urban children's hospital
were reviewed. Group A beta-hemolytic streptococci were isolated from blood
cultures from 17 children over a three-year period. Systemic illnesses that
may have predisposed these children to GAS bacteremia were identified in
seven patients: preceding varicella infection (four patients) or malignant
neoplasm/immunosuppressive therapy (three patients). Possible sources of
GAS included compromised integument (seven patients), the oropharynx (six
patients), or the lower respiratory tract (two patients). The clinical
manifestations of GAS sepsis included the following: fever (15 patients);
arthritis or arthralgias (four patients); cellulitis (three patients);
maculopapular eruption (one patient); petechial or pustular exanthems
(three patients); osteomyelitis (two patients); cervical adenitis (one
patient); empyema (one patient); and meningitis with multiple brain
abscesses (one patient). Two patients died of apparent overwhelming GAS
sepsis while at home. Group A beta-hemolytic streptococcal bacteremia can
present with a wide range of clinical manifestations and cause mild to
fulminant disease in children.
