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Clinical Pediatrics, Vol. 31, No. 10, 596-601 (1992)
DOI: 10.1177/000992289203101004

Emergence of Invasive Group A Streptococcal Disease Among Young Children

William Novotny, M.D.

Division of Critical Care

Howard Faden, M.D.

Division of Infectious Diseases Department of Pediatrics State University of New York School of Medicine Buffalo, New York

Luis Mosovich, M.D.

Division of Critical Care

Eight cases of invasive group A streptococcal disease in young children were reported over a three-month period, February to April 1990. The spectrum of clinical disease included: pneumonia with bacteremia (two patients), osteomyelitis/septic arthritis (three patients), epiglottitis/supraglottitis (two patients), and sepsis without a focus (one patient). Three cases followed chicken pox. Three children were in shock at the time of presentation, including one child who had a toxic shock-like appearance. Only four children had pharyngitis. Bacteremia was confirmed in three children and presumed in another three. All the subjects survived. Four isolates of group A streptococci were tested for exotoxin A, B, and C (A-0, B-4, C-1) production. These data confirm the reappearance of a highly invasive strain of group A streptococci capable of producing a variety of clinical diseases, including bacteremia and shock, in a significant proportion of victims.


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