Group A streptococcus is a type of bacteria commonly found in the throat and on the skin. The bacteria usually cause mild illnesses such as strep throat. Rarely, group A strep can invade other parts of the body and cause 2 very severe forms of infection:
Necrotizing fasciitis, which is also known as flesh-eating bacteria because it destroys skin, muscles, and soft tissue in the body
Group A Streptococcal toxic shock syndrome (GAS-TSS), which can cause kidney failure, breathing trouble, liver problems, low blood pressure, and an enlarged heart
Both of these infections can be deadly.
What is the cause?
Group A strep bacteria are spread by:
Sneezing or coughing
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:
Kidney disease that requires dialysis
Other long-term illness, especially heart or lung problems
Alcohol or IV drug abuse problems
An open wound from injury or surgery, or a skin condition such as chickenpox or shingles
You are also at higher risk if you are elderly or taking medicines such as steroids or anticancer drugs. These medicines can make it harder for your body to fight infection.
What are the symptoms?
Early symptoms of necrotizing fasciitis are:
Swelling and redness of the skin, especially at the site of a wound
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 and infected muscle and fat tissue below it are destroyed.
GAS-TSS can become severe very quickly. It affects many different parts of the body. Symptoms may include:
A flat red rash
Pain, sometimes severe, in the area of the rash
Very low blood pressure which can cause dizziness, confusion, and loss of consciousness
A few weeks after the infection starts, large areas of skin (usually the palms of the hands and soles of the feet) may peel off.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests to look for the bacteria may include:
Tests of fluid from sores
Tests of fluid from your throat, spine, or joints
If bacteria are found, they are tested to find which antibiotics will work best to treat the 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
Prompt surgery to remove skin and other tissue that is infected to prevent further spread
Treatment for GAS-TSS includes IV fluids, antibiotics, and medicines to keep a normal blood pressure and prevent damage to the brain, heart, kidneys, and other organs from not enough oxygen.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
If you are taking an antibiotic, take the medicine for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again.
Wash your hands well with soap and water after caring for any wounds, even when you have used gloves.
Put gloves, tissues, or other waste items soiled with blood or other body fluids in a separate bag from your regular trash. The bag should be sealed and leak-proof. For example, use 2 bags, putting one inside the other. Follow your local health department’s instructions for disposing of waste products.
Wash all linens or clothing soiled with blood or other body fluids separately from other laundry. Use detergent and a germicide. Follow your local health department’s instructions for safe washing and disposal of the water.
Ask your provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent group A strep?
To reduce your risk of getting group A strep:
If you have a severe sore throat, see your healthcare provider to check for strep throat.
Wash your hands often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also wash your hands before eating or touching your mouth, nose, or eyes.
Keep skin scrapes and wounds clean and watch for possible signs of infection, such as redness, swelling, drainage, or pain. See your healthcare provider right away if a wound looks like it is infected.
Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider’s instructions.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-09-24 Last reviewed: 2014-09-24
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.