Review of 17 Cases of Pneumonia Caused by Streptococcus pyogenes

Abstract

Streptococcus pyogenes is an uncommon cause of community-acquired pneumonia and there have been few recent specific accounts of the condition. To describe the current nature of this disease in the UK, data was gathered on patients with clinical pneumonia from whom Streptococcus pyogenes was cultured principally from blood or other relevant normally sterile sites. In the Harrogate and Northallerton districts of North Yorkshire, pneumonia accounted for nine (20%) cases and a quarter of all deaths in a complete sequence of 45 patients with Streptococcus pyogenes bacteraemia detected during the 16-year-period 1981-1996. An analysis is presented of those cases together with eight recent cases from counties York, Durham and Isle of Wight during 1995-1997. Of the total 17 cases, nine occurred in women and eight in men; the age range was 30-92 years. The organism was isolated from blood culture in 15 (88%) patients. Eight (47%) patients died, five within 1 day of hospitalisation. Fourteen (82%) cases occurred in the winter months October to March, including all the fatal cases and all eight in which a clinical 'viral' prodrome was observed. Predisposing medical or surgical conditions were present in 65% of the patients. Major complications included septicaemia, pleural reaction, shock, pulmonary cavitation, osteomyelitis and metastatic abscesses. Seven serotypes of Streptococcus pyogenes were encountered, with M-type 1 predominating (the cause in 60% of cases). All infections were community acquired; two small clusters of fatal pneumonia were seen.

Treatment of invasive streptococcal infection with a peptide derived from human high-molecular weight kininogen

“…34 It is estimated that invasive S pyogenes infections cause more than 150 000 deaths annually worldwide, 35 and the prognosis is especially poor in cases with lung hemorrhage. [36][37][38] Histologic examination of lungs recovered from patients who died of fulminant S pyogenes infection revealed severe intra-alveolar hemorrhage, 38 and in these patients the aPTT was dramatically prolonged. 38 Similar findings were observed in the present study when lungs and plasma samples from infected mice were analyzed.…”

Explosive Pleurisy Related to Group A Streptococcal Infection: A Case Report and Literature Review

“…3 Explosive pleurisy has been reported in cases of GAS pneumonia. Explosive pleurisy was first described by Braman and Donat in 1986 when they reported two cases of rapidly progressive pleural effusions attributed to GAS.…”

“…Pneumonia related to GAS is known to be associated with a high rate of occurrence of pleural effusion and empyema, contributing to significant morbidity and mortality that may reach up to 50%, especially in the settings of streptococcal toxic shock syndrome. [1][2][3] Pneumonia related to GAS is rarely associated with a rapidly progressing pleural effusion termed "explosive pleurisy" that is usually a complicated exudative parapneumonic effusion that is considered a medical emergency requiring immediate intervention.…”

Invasive group A streptococcal infections in childhood: Experience in North Yorkshire

“…This has been the subject of several published perspectives (such as on necrotising fasciitis, peri-partum infections, pneumonia and toxic shock) [21][22][23][24] and here we present and discuss the data it contains on paediatric invasive GAS disease.…”

“…M.R.D.Barnham, N.C. Weightman / International Congress Series 1289 (2006)[23][24][25][26][27][28][29] …”