Invasive group A streptococcal disease

Area of Science:

• Pediatric Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Scarlet fever and invasive group A streptococcal (iGAS) infections are increasing in pediatric populations.
• Group A Streptococcus (GAS) infections can lead to severe, multisystemic illness, including septic shock.
• Viral co-infections, such as influenza, may increase the risk of invasive GAS disease.

Observation:

• Two pediatric patients presented with severe illness characterized by cough, sore throat, and fever, progressing to multisystemic involvement.
• Both patients experienced fluid-refractory septic shock requiring intensive care, intubation, and ionotropic support.
• Co-infection with influenza was identified in both cases.

Findings:

• Prompt treatment with early initiation of antibiotics led to successful recovery in both children.
• This case series underscores the potential severity of iGAS infections in children, particularly when co-occurring with influenza.
• Despite reported fatal cases, iGAS infections in the UK remain underreported in medical literature.

Implications:

• Early diagnosis and aggressive treatment are crucial for improving outcomes in pediatric iGAS infections.
• Increased vigilance for iGAS is warranted during periods of heightened scarlet fever and influenza activity.
• Further research and reporting are needed to fully understand the epidemiology and clinical spectrum of iGAS in the UK.