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Review of 17 cases of pneumonia caused by Streptococcus pyogenes
M Barnham1, N Weightman, A Anderson
1Department of Microbiology, Harrogate General Hospital, North Yorkshire, UK. mike.barnham@hhc-tr.northy.nhs.uk
Abstract:
Streptococcus pyogenes is an uncommon cause of community-acquired pneumonia and there have been few recent specific accounts of the condition. To describe the current nature of this disease in the UK, data was gathered on patients with clinical pneumonia from whom Streptococcus pyogenes was cultured principally from blood or other relevant normally sterile sites. In the Harrogate and Northallerton districts of North Yorkshire, pneumonia accounted for nine (20%) cases and a quarter of all deaths in a complete sequence of 45 patients with Streptococcus pyogenes bacteraemia detected during the 16-year-period 1981-1996. An analysis is presented of those cases together with eight recent cases from counties York, Durham and Isle of Wight during 1995-1997. Of the total 17 cases, nine occurred in women and eight in men; the age range was 30-92 years. The organism was isolated from blood culture in 15 (88%) patients. Eight (47%) patients died, five within 1 day of hospitalisation. Fourteen (82%) cases occurred in the winter months October to March, including all the fatal cases and all eight in which a clinical 'viral' prodrome was observed. Predisposing medical or surgical conditions were present in 65% of the patients. Major complications included septicaemia, pleural reaction, shock, pulmonary cavitation, osteomyelitis and metastatic abscesses. Seven serotypes of Streptococcus pyogenes were encountered, with M-type 1 predominating (the cause in 60% of cases). All infections were community acquired; two small clusters of fatal pneumonia were seen.
Insights
Streptococcus pyogenes is an uncommon cause of pneumonia. This study analyzed 17 UK cases, finding a high mortality rate (47%) and frequent complications, often linked to winter months and predisposing conditions.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Streptococcus pyogenes is an infrequent cause of community-acquired pneumonia.
- Recent specific accounts of this condition are limited.
- Understanding current trends is crucial for public health interventions.
Purpose of the Study:
- To describe the current epidemiology and clinical features of Streptococcus pyogenes pneumonia in the UK.
- To analyze patient demographics, clinical presentation, outcomes, and microbiological characteristics.
- To identify risk factors and complications associated with this infection.
Main Methods:
- Retrospective analysis of clinical pneumonia cases with Streptococcus pyogenes cultured from sterile sites.
- Data collected from Harrogate, Northallerton, York, Durham, and Isle of Wight districts.
- Inclusion of 17 cases diagnosed between 1981-1997.
Main Results:
- Of 17 cases (9 female, 8 male, aged 30-92), 47% were fatal.
- Most cases (88%) involved Streptococcus pyogenes bacteraemia, with 47% mortality.
- 82% of cases occurred in winter; 65% had predisposing conditions; M-type 1 was predominant (60%).
Conclusions:
- Streptococcus pyogenes pneumonia, though uncommon, carries a significant mortality risk.
- Winter seasonality, predisposing conditions, and M-type 1 are key factors.
- Prompt recognition and management are vital, especially in at-risk populations.