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Managing the deteriorating child with suspected group A Streptococcus infection

Mark Kempsell-Smith1, Claire Fitzsimons1

  • 1Birmingham Women's and Children's NHS Foundation Trust, Birmingham, England.

Nursing Children and Young People
|August 21, 2023
PubMed

Insights

Group A Streptococcus infections in children are usually mild but can lead to severe sepsis. This article reviews management strategies for severe Group A Streptococcus infections, including rare complications like toxic shock syndrome.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Group A Streptococcus (GAS) causes common childhood infections like pharyngitis and impetigo.
  • While typically mild, GAS can lead to severe, life-threatening conditions such as sepsis, toxic shock syndrome, and necrotizing fasciitis.
  • Prompt recognition and management are crucial for pediatric patients with severe GAS infections.

Purpose of the Study:

  • To provide an overview of Group A Streptococcus infections in children.
  • To highlight rare but severe complications: streptococcal toxic shock syndrome and necrotizing fasciitis.
  • To examine the management of deteriorating children with suspected GAS infection using a case study.

Main Methods:

  • Literature review of Group A Streptococcus infections and complications.
  • Case study presentation of a child with severe GAS infection.
  • Discussion of management principles including respiratory and hemodynamic support.

Main Results:

  • Most pediatric GAS infections are treatable with antibiotics.
  • Severe GAS infections require intensive support, potentially in a ward setting if PICU beds are unavailable.
  • The case study illustrates the critical steps in managing a deteriorating child.

Conclusions:

  • Group A Streptococcus infections necessitate awareness of potential severe outcomes.
  • Effective management of severe GAS infections involves comprehensive supportive care.
  • Early recognition and intervention are key to improving outcomes in critically ill children.

Keywords:
bacterial infectionscardiorespiratorychild healthclinicalcritical careinfectioninotropic agentsmechanical ventilationmedicinesnon-invasive ventilationrespiratorysepsisstreptococcusventilation

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