More than 100 different types of Group A Strep have been identified.
Common sites of infection include the upper respiratory tract; scarlet fever, which includes skin involvement and can be very mild or extremely serious; strep pneumonia (which can also be quite serious); strep skin infections (such as impetigo); strep vaginitis in pre-pubertal girls; and strep bacteremia (or strep in the bloodstream), which can then lead to meningitis, brain abscess, bone infections, joint infections, or even endocarditis (an infection of the valves of the heart).
Strep pharyngitis (commonly known as “strep throat “) is one of the most common strep infections. Strep throat is contagious until antibiotic therapy has been in place for at least 24 hours. It is spread by close contact, both via respiratory droplets and by touch.
The diagnosis of a systemic strep infection should at least be entertained when there is vomiting lasting longer than 24 hours, a high fever, and an elevated white blood count in an ill-appearing child.
The presence of group A strep infection can be confirmed by performing a culture of the suspected site. Depending on a child’s symptoms, a throat culture, wound culture, blood culture, and/or a blood test may be obtained to evaluate for strep infection.
In the case of strep throat, rapid strep tests can give almost immediate results in the doctor’s office but may miss 10 to 20% of infections. Throat cultures may take 1 to 2 days, but are able to detect infection 95% of the time.