[Bacteremia caused by beta-hemolytic group A streptococci]

The epidemiological, clinical and laboratory characteristic of group A beta-hemolytic streptococcal (GABHS) bacteremia in patients treated at the University Hospital of Infectious Diseases in Zagreb were analyzed. Of 51 cases of bacteremia due to GABHS seen over the past 15 years, 15 (29%) have been registered since 1987. The mean age of our patients was 25 years (range, 5 months to 87 years); and 29 (57%) were under 18. Ten (19%) patients died, 6 being less than 18 years of age. Forty-seven (92%) cases were community-acquired and 16 (32%) had underlying disease. Primary foci of infection, defined as a sites of inflammation that precedes bacteremia, included pharyngitis in 15 and erysipelas/cellulitis in 16 patients. Six patients had no focus of infection. Shock was recorded in 4 patients, all of whom died. Seven patients had a rash, in 5 the rash was typical of scarlet fever. Of the 6 children who died 4 were previously healthy and they all died within 24 hours following admission, and were sick at least 48 hours before admission to our hospital. Our experience suggests that serious GABHS infections may appear in children, that it requires prompt recognition and treatment and that a worldwide change in the virulence of GABHS may have occurred.