Streptococcal Infections (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Group A streptococcal infections facts
- What is group A Streptococcus (GAS)?
- How are group A streptococcal (GAS) infections contracted?
- What diseases are caused by group A streptococcal infection?
- What are the symptoms and signs of GAS infections?
- What is invasive group A streptococcal disease? Who is most at risk for getting invasive GAS disease?
- What are the symptoms and signs of necrotizing fasciitis?
- What are the signs and symptoms of toxic shock syndrome (TSS)?
- How are group A streptococcal (GAS) infections diagnosed?
- What is the treatment for invasive group A streptococcal disease?
- What complications are seen with group A streptococcal infections?
- Can group A streptococcal infections be prevented?
- What is the prognosis for group A streptococcal infections?
- Where can people find more information about group A streptococcal infections?
What are the symptoms and signs of necrotizing fasciitis?
Early signs and symptoms of necrotizing fasciitis include fever, severe pain, swelling, and erythema (redness) at the wound site or site where GAS organisms entered the body. The pain and swelling may extend well beyond the erythema. Skin changes may resemble cellulitis initially, but ulceration, scabs, and fluid draining from the site develop, sometimes rapidly (Fig. 3). GAS organisms then can spread to the bloodstream and the patient can develop bacteremia and septic shock with high fever and a low blood pressure. About 20% of patients with necrotizing fasciitis caused by GAS will die from the infection.
What are the signs and symptoms of toxic shock syndrome (TSS)?
Early symptoms of TSS are nonspecific and often begin with flu-like symptoms of mild fever and malaise. However, TSS often suddenly advances with symptoms of high fever, nausea, vomiting, diarrhea, skin rash, and a low blood pressure. If it progresses, confusion, headaches, seizures, and skin loss from the palms of the hands and from the soles of the feet can occur. The blood pressure can become dangerously low so that body organs are not profused with enough blood, and if multiorgan failure develops, the patient often dies. The death rate varies from 5%-60%, depending on how well the patient can respond to treatment. GAS bacteria and Staphylococcus aureus are the predominant bacteria that cause TSS.
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