Severe invasive group a streptococcal infections: A subject review

N. A. Halsey, J. S. Abramson, P. J. Chesney, M. C. Fisher, M. A. Gerber, D. S. Gromisch, S. Kohl, S. M. Marcy, D. L. Murray, G. D. Overturf, R. J. Whitley, R. Yogev, G. Peter, C. B. Hall, B. Schwartz, R. Breiman, M. C. Hardegree, R. F. Jacobs, N. E. MacDonald, W. A. OrensteinN. R. Rabinovich

Research output: Contribution to journalReview article

104 Citations (Scopus)

Abstract

The course of severe invasive group A β-hemolytic streptococcal (GABHS) infections is often precipitous, requiring prompt diagnosis and rapid initiation of appropriate therapy. Therefore, physicians must have a high index of suspicion of this disease, particularly in patients at increased risk (eg, those with varicella or diabetes mellitus). Although a relationship between the use of nonsteroidal antiinflammatory drugs and severe invasive GABHS infections has been suggested, at present data on which to base a clinical decision about the use or restriction of nonsteroidal antiinflammatory drugs in children with varicella are insufficient. When necrotizing fasciitis is suspected, prompt surgical drainage, debridement, fasciotomy, or amputation often is necessary. Many experts recommend intravenously administered penicillin G and clindamycin for the treatment of invasive GABHS infections on the basis of animal studies. Some evidence exists that intravenous immunoglobulin given in addition to appropriate antimicrobial and surgical therapy may be beneficial. Although chemoprophylaxis for household contacts of persons with invasive GABHS infections has been considered by some experts, the limited available data indicate that the risk of secondary cases is low (2.9 per 1000) and data about the effectiveness of any drug are insufficient to make recommendations. Because of the low risk of secondary cases of invasive GABHS infections in schools or child care facilities, chemoprophylaxis is not indicated in these settings. Routine immunization of all healthy children against varicella is recommended and is an effective means to decrease the risk of invasive GABHS infections.

Original languageEnglish (US)
Pages (from-to)136-140
Number of pages5
JournalPediatrics
Volume101
Issue number1 I
DOIs
StatePublished - Jan 1 1998

Fingerprint

Streptococcal Infections
Chickenpox
Infection
Chemoprevention
Anti-Inflammatory Agents
Pharmaceutical Preparations
Necrotizing Fasciitis
Penicillin G
Clindamycin
Intravenous Immunoglobulins
Debridement
Child Care
Amputation
Drainage
Immunization
Diabetes Mellitus
Therapeutics
Physicians

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Halsey, N. A., Abramson, J. S., Chesney, P. J., Fisher, M. C., Gerber, M. A., Gromisch, D. S., ... Rabinovich, N. R. (1998). Severe invasive group a streptococcal infections: A subject review. Pediatrics, 101(1 I), 136-140. https://doi.org/10.1542/peds.101.1.136

Severe invasive group a streptococcal infections : A subject review. / Halsey, N. A.; Abramson, J. S.; Chesney, P. J.; Fisher, M. C.; Gerber, M. A.; Gromisch, D. S.; Kohl, S.; Marcy, S. M.; Murray, D. L.; Overturf, G. D.; Whitley, R. J.; Yogev, R.; Peter, G.; Hall, C. B.; Schwartz, B.; Breiman, R.; Hardegree, M. C.; Jacobs, R. F.; MacDonald, N. E.; Orenstein, W. A.; Rabinovich, N. R.

In: Pediatrics, Vol. 101, No. 1 I, 01.01.1998, p. 136-140.

Research output: Contribution to journalReview article

Halsey, NA, Abramson, JS, Chesney, PJ, Fisher, MC, Gerber, MA, Gromisch, DS, Kohl, S, Marcy, SM, Murray, DL, Overturf, GD, Whitley, RJ, Yogev, R, Peter, G, Hall, CB, Schwartz, B, Breiman, R, Hardegree, MC, Jacobs, RF, MacDonald, NE, Orenstein, WA & Rabinovich, NR 1998, 'Severe invasive group a streptococcal infections: A subject review', Pediatrics, vol. 101, no. 1 I, pp. 136-140. https://doi.org/10.1542/peds.101.1.136
Halsey NA, Abramson JS, Chesney PJ, Fisher MC, Gerber MA, Gromisch DS et al. Severe invasive group a streptococcal infections: A subject review. Pediatrics. 1998 Jan 1;101(1 I):136-140. https://doi.org/10.1542/peds.101.1.136
Halsey, N. A. ; Abramson, J. S. ; Chesney, P. J. ; Fisher, M. C. ; Gerber, M. A. ; Gromisch, D. S. ; Kohl, S. ; Marcy, S. M. ; Murray, D. L. ; Overturf, G. D. ; Whitley, R. J. ; Yogev, R. ; Peter, G. ; Hall, C. B. ; Schwartz, B. ; Breiman, R. ; Hardegree, M. C. ; Jacobs, R. F. ; MacDonald, N. E. ; Orenstein, W. A. ; Rabinovich, N. R. / Severe invasive group a streptococcal infections : A subject review. In: Pediatrics. 1998 ; Vol. 101, No. 1 I. pp. 136-140.
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