GROUP-A STREPTOCOCCAL DISEASE

With the decline in incidence of severe disease due to group A beta-he molytic streptococci (GABHS) in developed countries over the past 4 de cades most young clinicians have little experience with highly fatal d iseases once associated with this organism. More recent reports, howev er, indicate that the epidemiology of GABHS disease has been changing over the past several years and severe disease is remerging. This revi ew will focus on some of these changes and related developments; speci fically, streptococcal pyoderma, streptococcal antigen detection kits, acute rheumatic fever and severe invasive streptococcal disease.