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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
Summary
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.
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