PEDIATRICS Vol. 89 No. 4 April 1992, pp. 743-746
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Suppurative Group A beta-Hemolytic Streptococcal Infections in Children

Mobeen H. Rathore MD1, Leslie L. Barton MD2, and Edward L. Kaplan MD3

1 From the Department of Pediatrics, University Florida Health Science Center, Jacksonville
2 From the Department of Pediatrics, University of Arizona Health Sciences Center, Tucson
3 From the Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis

Group A beta-hemolytic streptococci (GABHS) have once again become an important cause of serious suppurative disease in children. A 100% increase in the rate of GABHS bacteremia and an increased frequency in GABHS bacteremia in previously healthy children were observed in 1989 through 1990 compared with 1984 to 1988. Streptococcal isolates were characterized and patient demographic data were tabulated from children hospitalized with GABHS suppurative infections in 1989 through 1990. The differences in clinical manifestations and strains of GABHS were examined in patients with bacteremia, with or without focal site of infection, and in those with focal infections without bacteremia. Bacteremic children were significantly younger and had higher white blood cell counts at admission. No patient had a toxic shock-like syndrome. Although no specific strain was associated with suppurative infections, serum opacity reaction-negative organisms were more frequently associated with focal infections without bacteremia. The data suggest that GABHS may have become more virulent. Physicians should consider GABHS as an important cause of serious suppurative infection in children.

Key Words: Group A Streptococcus • bacteremia • focal infection

Submitted on June 18, 1991
Accepted on September 30, 1991




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