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Rationale and Consensus Definition

The Working Group on Severe Streptococcal Infections; Robert F. Breiman, MD; Jeffrey P. Davis, MD; Richard R. Facklam, PhD; Barry M. Gray, MD; Charles W. Hoge, MD; Edward L. Kaplan, MD; Edward A. Mortimer, MD; Patrick M. Schlievert, PhD; Benjamin Schwartz, MD; Dennis L. Stevens, MD, PhD; James K. Todd, MD

JAMA. 1993;269(3):390-391.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

GROUP A streptococcus (Streptococcus pyogenes) may cause a variety of illnesses ranging from very common, usually clinically mild conditions such as pharyngitis and impetigo to less common severe infections including septicemia and pneumonia. In 1987, Cone et al¹ described two patients with severe group A streptococcal infections having clinical features similar to the staphylococcal toxic shock syndrome. This syndrome, designated the "streptococcal toxic shock—like syndrome" or the "toxic streptococcal syndrome,"² was further characterized by Stevens et al³ in a series of 20 patients. Most patients included in this series were less than 50 years old and otherwise healthy. All had invasive group A streptococcal infections characterized by signs including shock, multi—organ system involvement, and rapidly progressive, destructive soft-tissue infection (necrotizing fasciitis). The case-fatality rate was 30% even though most patients received appropriate antimicrobial therapy, supportive care, and, where necessary, surgical débridement. Ten available isolates were serotyped and . . . [Full Text PDF of this Article]

Author Affiliations
Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Ga; Bureau of Public Health, Wisconsin Division of Health, Madison; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Ga; Department of Pediatrics, University of Alabama School of Medicine, Birmingham; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Ga; Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis; Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio; Department of Microbiology, University of Minnesota, Minneapolis; Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Ga; Department of Medicine, Boise Veterans Administration Hospital, Boise, Idaho; Department of Pediatrics, University of Colorado School of Medicine, Denver

From The Working Group on Severe Streptococcal Infections.

Footnotes
A complete list of the participants in this research study appears in the acknowledgments.

Reprint requests to Respiratory Diseases Branch, Mailstop C-09, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333 (Benjamin Schwartz, MD).

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