{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:12:36Z","timestamp":1773180756874,"version":"3.50.1"},"reference-count":46,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,11]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>\n                  <jats:italic>Streptococcus pyogenes<\/jats:italic> is a common cause of infection. Since 2010, the Centers for Disease Control has noted a 24% rise in invasive <jats:italic>S. pyogenes<\/jats:italic> infections with a mortality rate of 10%. We present a case series and review of the English literature. Two patients presented with findings concerning for appendicitis, each underwent laparoscopic appendectomies. Both had diffuse peritoneal inflammation without appendicitis, cultures grew <jats:italic>S. pyogenes<\/jats:italic> and both recovered with appropriate antibiotics. Thirty cases were identified in a review of the English literature. The average age was 27 years, 75% were in women, 9% were immunocompromised, 15% had rashes and 88% underwent surgical intervention. Previous work identified female gender, immunosuppression and preceding varicella infection as risk factors for invasive <jats:italic>S. pyogenes.<\/jats:italic> Given the similarities to appendicitis, early suspicion can influence antibiotic therapy and possibly improve outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2019-230490","type":"journal-article","created":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T18:41:34Z","timestamp":1569868894000},"page":"e230490","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["<i>Streptococcus pyogenes<\/i> peritonitis: a rare, lethal imitator of appendicitis"],"prefix":"10.1136","volume":"12","author":[{"given":"Matthew","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Surgery, Albany Medical College, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Bartscherer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albany Medical College, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellis","family":"Tobin","sequence":"additional","affiliation":[{"name":"Upstate Infectious Disease, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Tafen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Albany Medical College, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"2025082713015322000_12.9.e230490.1","doi-asserted-by":"crossref","unstructured":"Stevens DL . Invasive Group A Streptococcus Infections. Clin Infect Dis 1992.","DOI":"10.1093\/clinids\/14.1.2"},{"key":"2025082713015322000_12.9.e230490.2","unstructured":"In: Ferretti JJ , Stevens DL , Fischetti VA , eds. \u00a0Streptococcus pyogenes : Basic Biology to Clinical Manifestations. \u00a0Oklahoma City (OK: University of Oklahoma Health Sciences Center, 2016."},{"key":"2025082713015322000_12.9.e230490.3","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report\u00a0Emerging Infections Program Network, Group A Streptococcus. 2012."},{"key":"2025082713015322000_12.9.e230490.4","unstructured":"Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report, Emerging Infections Program Network\u00a0Group A Streptococcus, 2015."},{"key":"2025082713015322000_12.9.e230490.5","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1089\/sur.2012.038","article-title":"Management of Primary Group A Streptococcal Peritonitis: A Systematic Review","volume":"14","author":"Westwood","year":"2013","journal-title":"Surg Infect"},{"key":"2025082713015322000_12.9.e230490.6","doi-asserted-by":"crossref","unstructured":"Tapiainen T , Launonen S , Renko M , et al . Invasive Group A Streptococcal Infections in Children: A Nationwide Survey in Finland. 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