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Collections under which this article appears: Tumors

PEDIATRICS Vol. 112 No. 1 July 2003, pp. e61-e65

 

A Family Cluster of Five Cases of Group A Streptococcal Pneumonia

Sumita Roy, MD^*, John R. Schreiber, MD, MPH^*, Chandy C. John, MD, MS^*, Edward L. Kaplan, MD, Benigno Rodriguez, MD, Robert A. Salata, MD and Elizabeth Palavecino, MD

^* Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
World Health Organization Collaborating Center for Reference and Research on Streptococci, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio

A cluster of 5 family members, a mother and 4 children, were hospitalized for severe group A Streptococcus (GAS) pneumonia. Three family members had complications: sepsis (1), empyema (2), and a sterile parapneumonic effusion (1). Two additional family members had symptoms of upper respiratory tract infection, and 1 was hospitalized for these symptoms. GAS was isolated from the blood of 1 patient, the pleural fluid of 2 patients, and the oropharynx of 6 patients. Pulsed field gel electrophoresis testing revealed an identical deoxyribonucleic acid pattern in all 7 isolates. Genotyping revealed the speA gene and serotyping the T-1, M-1 serotype in all isolates. This family cluster of invasive GAS disease is the largest reported to date, with an attack rate of 41.7% (5 of 12 family members). This report provides further support for antibiotic prophylaxis of close contacts of individuals with invasive GAS disease.

Key Words: group A Streptococcus • family • cluster • invasive • pneumonia

Abbreviations: GAS, group A Streptococcus, streptococcal • STSS, streptococcal toxic shock syndrome • RBCH, Rainbow Babies and Children’s Hospital • PFGE, pulsed-field gel electrophoresis • HLA, human histocompatibility leukocyte antigen

Received for publication Dec 26, 2002; accepted Mar 18, 2003.
 

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