Pediatric Infectious Disease

Register      Login

VOLUME 1 , ISSUE 3 ( July-September, 2019 ) > List of Articles


Streptococcal Infections in Children: An Update

Prakash K Wari, Siddappa F Dandinavar, Raghavendraswami Amoghimath, Roopali Desai, HR Puneeth

Keywords : Acute rheumatic fever, Group A Streptococcus, Streptococcal pharyngitis

Citation Information : Wari PK, Dandinavar SF, Amoghimath R, Desai R, Puneeth H. Streptococcal Infections in Children: An Update. Pediatr Inf Dis 2019; 1 (3):114-119.

DOI: 10.5005/jp-journals-10081-1211

License: CC BY-NC 4.0

Published Online: 16-07-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Streptococcus is the general term for a diverse group of gram-positive cocci that appear in chains or pairs. The most prevalent of the human streptococcal pathogens are the Lancefield group A Streptococcus (GAS). This review article provides an update on group A streptococcal infections with key highlights on classification, presentation, the latest diagnostic criteria, management protocols, and complications. Background: Group A Streptococcus is involved in the pathogenesis of a wide variety of pathologic conditions varying from noninvasive infections such as pharyngitis, erysipelas, scarlet fever, and cellulitis to invasive diseases, such as bacterial sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis. It is also linked with nonsuppurative and postinfectious immunological sequelae, such as acute rheumatic fever (ARF), poststreptococcal glomerulonephritis (PSGN) and pediatric autoimmune neuropsychiatric disorder associated with Streptococcus pyogenes (PANDAS). Globally around 18 million people suffer from GAS-related illnesses. Conclusion: Group A streptococcal infections have a high prevalence and morbidity across the globe, especially in developing countries. Children older than 3 years have a higher risk of such complications necessitating need for proper diagnosis and treatment.

PDF Share
  1. Kilian M. Streptococcus and Enterococcus. Greenwood D. Medical Micobiology, A guide to Medical infections, 18th ed., Churchill Livingstone Elsevier: Edinburgh; 2012. p. 183.
  2. Dietrich ML, Steele RW. Group A Streptococcus. Pediatr Rev 2018;39(8):379–391. DOI: 10.1542/pir.2017-0207.
  3. Pichichero ME. Group a streptococcal tonsillopharyngitis: cost-effective diagnosis and treatment. Ann Emerg Med 1995;25(3):390. DOI: 10.1016/S0196-0644(95)70300-4.
  4. Tsevat J, Kotagal UR. Management of sore throats in children: a cost effectiveness analysis. Arch Pediatr Adolesc Med 1999;153(7):681. DOI: 10.1001/archpedi.153.7.681.
  5. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the infectious diseases society of America. Clin Infect Dis 2012;55(10):e86. DOI: 10.1093/cid/cis629.
  6. Kronman MP, Zhou C, Mangione-Smith R. Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections. Pediatrics 2014;134(4):e956. DOI: 10.1542/peds.2014-0605.
  7. Kumar RK, Tandon R. Rheumatic fever & rheumatic heart disease: the last 50 years. Indian J Med Res 2013;137(4):643.
  8. Robert R. Acute pharyngitis. Lliegman. ed. Nelson's Textbook of Pediatrics, 20th ed., Philadelphia: Elsevier; 2016. p. 2017.
  9. Beaton A, Carapetis J. The 2015 revision of the Jones criteria for the diagnosis of acute rheumatic fever: implications for practice in low-income and middle-income countries. Heart Asia 2015;7(2):7–11. DOI: 10.1136/heartasia-2015-010648.
  10. Laupland KB, Davies HD, Low DE, et al. Invasive group A streptococcal disease in children and association with varicella-zoster virus infection. Ontario group a streptococcal study group. Pediatrics 2000;105:E60. DOI: 10.1542/peds.105.5.e60.
  11. Tapiainen T, Launonen S, Renko M, et al. Invasive group a streptococcal infections in children: a nationwide survey in Finland. Pediatr Infect Dis J 2016;35(2):123. DOI: 10.1097/INF.0000000000000945.
  12. (accessed on February 15, 2018).
  13. Nelson GE, Pondo T, Toews KA, et al. Epidemiology of invasive group a streptococcal infections in the United States, 2005-2012. Clin Infect Dis 2016;63(4):478. DOI: 10.1093/cid/ciw248.
  14. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs). ABCs Report: group A Streptococcus, 2012. findings/survreports/gas12.html (accessed on August 06, 2014).
  15. Lamagni TL, Neal S, Keshishian C, et al. Severe Streptococcus pyogenes infections, United Kingdom, 2003–2004. Emerg Infect Dis 2008;14(2):202. DOI: 10.3201/eid1402.070888.
  16. Shulman S. Group A Streptococcus. Kliegman. ed. Nelson's Textbook of Pediatrics, 20th ed., Philadelphia: Elsevier; 2016. p. 1327.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.