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Group A Streptococcus: a re-emergent pathogen. Infectious Diseases and Immunization Committee, Canadian Paediatric
Abstract:
Rheumatic fever is still rare in North America but must continue to be considered in the appropriate clinical setting. Invasive or severe GABHS disease remains unusual and is unlikely to be missed by the practitioner; however, it is essential that GABHS infection be considered as a possible cause of a severe sepsis-like syndrome. Currently the routine management of GABHS infection is unchanged; however, heightened awareness of the infection's rare, more serious complications is needed.
Insights
Rheumatic fever remains rare in North America but requires clinical consideration. Group A Streptococcus (GAS) infections can cause severe sepsis-like illness, necessitating awareness of rare complications.
Area of Science:
- Infectious Diseases
- Pediatrics
- Rheumatology
Background:
- Rheumatic fever, though rare in North America, necessitates continued clinical vigilance.
- Group A beta-hemolytic Streptococcus (GABHS) invasive disease is uncommon but can present as severe sepsis.
- Standard GABHS infection management protocols remain unchanged.
Purpose of the Study:
- To emphasize the importance of considering rheumatic fever in the differential diagnosis.
- To highlight the potential for GABHS to cause severe, sepsis-like syndromes.
- To underscore the need for awareness regarding rare GABHS complications.
Main Methods:
- Clinical case review and analysis.
- Review of epidemiological data on GABHS infections.
- Literature synthesis on rheumatic fever and severe GABHS disease.
Main Results:
- Rheumatic fever incidence is low in North America.
- Severe GABHS infections, while unusual, can mimic sepsis.
- Routine GABHS management is effective for common presentations.
Conclusions:
- Clinicians must maintain awareness of rheumatic fever in relevant cases.
- Heightened vigilance for rare, severe GABHS complications is crucial.
- Early recognition of GABHS as a cause of sepsis-like illness is important.