Group A Strep Invasive Disease

What is group A strep invasive disease?

Group A strep invasive diseases are serious infections caused by a type of bacteria called group A streptococcus, group A strep, or GAS. The bacteria are found most often in the throat and on the skin. They usually cause relatively mild illnesses such as strep throat or impetigo. Rarely, group A strep can cause 2 very severe forms of invasive strep infection:

• necrotizing fasciitis (sometimes described by the media as “flesh-eating bacteria”)
• streptococcal toxic shock syndrome, or STSS.

Both of these infections can be deadly.

What is the cause?

Group A strep bacteria are spread by:

• direct contact with secretions from the nose and throat of infected people
• contact with infected wounds or sores on the skin

The bacteria can get into the body through sores or other breaks in your skin, such as cuts or other wounds.

Only a few people who come into contact with group A strep get life-threatening infections. You have a higher risk of getting a very severe infection if you have:

• a chronic illness, especially heart or lung problems
• cancer
• diabetes
• AIDS/HIV
• kidney disease that requires dialysis
• alcohol or IV drug abuse problems
• an open wound (from injury, surgery, or a chronic skin condition)

You are also at higher risk if you are elderly or taking medicines such as steroids or anticancer drugs. These medicines can weaken your immune system, making it harder for you to fight infection.

What are the symptoms?

Early symptoms of necrotizing fasciitis are:

• fever
• severe pain
• swelling and redness at the site of a wound

The infection may start destroying muscle and fat tissue. A rash will develop, changing color after 1 to 2 days from red to purple to blue. Blisters with yellow fluid inside the blisters will form. In 4 to 5 days the skin starts to die. This is called gangrene. After 7 to 10 days the dead skin falls off.

Streptococcal toxic shock syndrome is an infection that can become severe very quickly. It affects many different parts of the body. It can cause kidney failure, breathing trouble, liver problems, low blood pressure, and an enlarged heart. Early symptoms may include:

• fever
• dizziness
• confusion
• a flat red rash
• abdominal pain

Streptococcal toxic shock syndrome is not the same as another condition called toxic shock syndrome, which is linked to tampon use and caused by a different type of bacteria (staph bacteria). The strep infection is even more serious than this serious staph infection.

How is it treated?

Invasive strep disease is a life-threatening condition. You usually need to stay at the hospital, possibly in an intensive care unit.

• Treatment for necrotizing fasciitis includes:
  • careful cleaning of the wound
  • antibiotics to treat the infection
  • surgery to remove skin and other tissue that is infected to prevent further spread
• Treatment for streptococcal toxic shock syndrome includes IV fluids, antibiotics, and medicines to keep a normal blood pressure to prevent organ damage

You may need a specialist in infections or critical care medicine to take care of you.

How long will the effects last?

Recovery from the infection depends on many factors, such as your age, other medical problems you have, and how quickly the infection is diagnosed and treated. Group A strep infection can be fatal. The earlier you get treatment, the greater your chance of surviving the infection.

Streptococcal toxic shock syndrome damages the kidneys, but people who survive the infection usually have normal kidney function 4 to 6 weeks after treatment is completed.

How can I help prevent the spread of infection?

To avoid spreading group A strep:

• Wash your hands well with soap and water after coughing and sneezing, before you prepare foods, and before you eat.
• Wash your hands well with soap and water after caring for any wounds, even when you have used gloves.
• If you have a sore throat, see your healthcare provider to check for strep throat.
• Keep skin scrapes and wounds clean and watch for possible signs of infection, such as redness, swelling, drainage, or pain.
• Dispose of wound bandages, gloves, etc., by keeping them bagged separately from other trash. Keep the bagged, contaminated trash in a place where no one else will touch it. Mark the bag “dirty bandages” and leave it in the trash container for the trash collectors. Your healthcare provider or hospital may give you special bags for this trash that are marked “biohazard.”

See your healthcare provider right away if a wound looks like it is infected, especially if you have a fever.