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Multisystem group A beta-hemolytic streptococcal disease in children.

M A Jackson1, V F Burry, L C Olson

  • 1Department of Pediatrics, University of Missouri-Kansas City School of Medicine.

Reviews of Infectious Diseases
|September 1, 1991
PubMed
Summary

Severe streptococcal infections in children can cause multisystem dysfunction, affecting the brain, kidneys, and liver. Early recognition is crucial for prompt treatment of this serious condition.

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Area of Science:

  • Pediatric Infectious Diseases
  • Toxicology
  • Critical Care Medicine

Background:

  • Streptococcal infections can lead to severe, multisystem complications in children.
  • Multisystem dysfunction presents a diagnostic challenge due to diverse clinical manifestations.

Observation:

  • Eight children (3-11 years) presented with severe streptococcal infection and toxic condition.
  • Prominent symptoms included encephalopathy, severe hyperesthesia, rash, hyponatremia, musculoskeletal complaints, renal, and hepatic involvement.
  • Five patients required fluid resuscitation; three needed surgical intervention for occult infections.

Findings:

  • All patients exhibited renal involvement and hyponatremia.
  • Encephalopathic symptoms were observed, with mild pleocytosis in cerebrospinal fluid in two cases.

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  • Hepatopathy was present in four of five patients, characterized by hyperbilirubinemia and elevated liver enzymes.

    • Implications:

    • A high index of suspicion is essential for diagnosing severe streptococcal infections in children.
    • Prompt recognition and initiation of appropriate therapy are critical for managing multisystem dysfunction.
    • Understanding the varied clinical presentations aids in timely and effective pediatric critical care.