Streptococcal Infections (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Group A streptococcal infections facts
- What is group A Streptococcus (GAS)?
- How are group A streptococcal (GAS) infections contracted?
- What diseases are caused by group A streptococcal infection?
- What are the symptoms and signs of GAS infections?
- What is invasive group A streptococcal disease? Who is most at risk for getting invasive GAS disease?
- What are the symptoms and signs of necrotizing fasciitis?
- What are the signs and symptoms of toxic shock syndrome (TSS)?
- How are group A streptococcal (GAS) infections diagnosed?
- What is the treatment for invasive group A streptococcal disease?
- What complications are seen with group A streptococcal infections?
- Can group A streptococcal infections be prevented?
- What is the prognosis for group A streptococcal infections?
- Where can people find more information about group A streptococcal infections?
What is invasive group A streptococcal disease? Who is most at risk for getting invasive GAS disease?
Invasive GAS disease is when GAS organisms invade and infect organs or organ systems in the body (for example, GAS infections of the blood, muscle, fatty tissue, or the lungs). These are serious infections, and the mortality rate (death rate) varies from about 10%-60%, depending on the area(s) of the body infected. The most severe forms of invasive GAS infections are with necrotizing fasciitis and streptococcal toxic shock syndrome described below. People at higher risk for getting invasive forms of GAS are individuals with chronic diseases and immunosuppressed patients (for example, cancer, diabetes, and renal failure patients, and people taking steroid-type medications). Most healthy people do not get this type of GAS disease, but if they have skin breaks (cuts, abrasions, recent surgical sites), these individuals have a higher risk of GAS disease than people without skin breaks.
Other patients who are at risk for invasive GAS disease are patients with GAS infections that can easily progress into deep fat and muscle (for example, a GAS infection near the scrotum or anus or an abscess in the skin) and can progress to necrotizing fasciitis. Toxic shock syndrome was initially found to be associated with vaginal infections secondary to tampon use (or inappropriate use such as leaving a tampon in the vagina for an extended time). However, any patient who has a wound or surgery that requires packing to reduce bleeding (for example, nasal packing for severe nose bleeding) is at increased risk for toxic shock syndrome. Toxic shock syndrome may also be caused by a different bacterium called Staphylococcus.
Consequently, risk factors for GAS organisms to cause infection include suppression of the immune system (see above), open wounds or wound packing, or tampons that may promote GAS survival and proliferation. Children and the elderly are at higher risk to become infected with GAS.
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