Dynamed summary: Group A streptococcus

Background

Group A Streptococcus (GAS) is a major human pathogen associated with a broad spectrum of clinical illnesses including:

  • acute infections such as:
    • pharyngitis
    • skin and soft tissue infections, such as impetigo, cellulitis, and erysipelas
    • severe systemic infections, such as toxic shock syndrome
  • nonsuppurative complications such as:
    • acute rheumatic fever
    • poststreptococcal glomerulonephritis
  • More than 200 serotypes or genotypes exist which, to a limited extent, correlate with disease manifestation.
  • Transmission is typically person to person via respiratory droplets or direct skin contact.

Evaluation

Diagnosis is typically based on isolation of the organism from:

  • throat culture, the gold standard for diagnosis of acute pharyngitis, or
  • a normally sterile site for diagnosis of invasive disease

Management

  • Group A Streptococcus (GAS)) remains widely susceptible to penicillin, which is the treatment of choice for most illnesses.
  • In severe toxin-mediated diseases, such as GAS necrotizing fasciitis or toxic shock syndrome:
    • clindamycin, a protein synthesis inhibitor, is often added to penicillin
    • IV immunoglobulin is often considered as an adjunctive therapy but supportive data is limited

Read the full summary here (OpenAthens account required).

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