TABLE 1.
Clinical symptoms and epidemiology of the major group A Streptococcus infections
| Disease | Sign(s) and/or symptom(s) | Estimated global incidencea | Associated M type(s)b | Reference(s) |
|---|---|---|---|---|
| Superficial | ||||
| Pharyngitis | Sore throat, malaise, fever | >600 million/yr | 1, 3, 5, 6, 12, 14, 17, 19, 24 | 6, 46, 58, 62, 63 |
| Scarlet fever | Deep red rash, “strawberry tongue,” exudative pharyngitis | 61, 64–66 | ||
| Impetigo | Skin pustules that mature into honey-colored scabs | 111 million | 33, 41, 42, 52, 53, 70 | 6, 69, 75 |
| Sequelae | ||||
| Acute rheumatic fever | Polyarthritis, carditis, rapid and jerky movements, rash, subcutaneous nodules | >471,000/yr | 1, 3, 5, 6, 11, 12, 14, 17, 18, 19, 24, 27, 29, 30, 32, 41 | 72, 73, 589–591 |
| Rheumatic heart disease | Mitral and/or aortic regurgitation with possible stenosis over time | 15.6 million–19.6 million | 66 | |
| Acute poststreptococcal glomerulonephritis | Edema, hypertension, urinary sediment abnormalities, complement deficiency | >470,000/yr | 1, 4, 12, 49, 55, 57, 60 | 66, 75, 591 |
| Invasive | ||||
| Bacteremia | High fever, nausea, vomiting | 660,000 cases and 160,000 deaths/yr (all invasive diseases) | 592 | |
| Puerperal sepsis | Fever, chills, abdominal pain in a pregnant or early postpartum woman | 28 | 593 | |
| Cellulitis | Acute, tender, erythematous, and swollen area of skin | 594 | ||
| Necrotizing fasciitis | Fever, exquisitely tender skin lesions, vomiting, diarrhea, toxemia, tissue destruction | 1, 3, 28 | 285 | |
| Streptococcal toxic shock syndrome | High fever, rapid-onset hypotension, accelerated multisystem failure | 1, 3 | 291 |