Severe pulmonary hemorrhage in patients with serious group A streptococcalinfections: Report of two cases

Severe pulmonary hemorrhage was observed in two patients who died of seriou s group A streptococcal infections. These two patients initially presented with fever and sore throat. This was followed by sudden onset of septicemia caused by the bacteria and by the subsequent development of severe pulmona ry hemorrhage. Hemoptysis, cyanosis, and dyspnea were observed prior to dea th in both cases. This pulmonary lesion resulted in asphyxia and sudden dea th in one patient. Pathological examinations of the lung revealed severe in traalveolar hemorrhage, with no evidence of inflammation or necrosis of the pulmonary tissue. There was no evidence of aspiration of blood due to hemo rrhage in the upper respiratory or alimentary tract. This visceral lesion a ppears to be an hitherto undescribed, novel clinicopathologic feature of pa tients with serious group A streptococcal infections.