{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:56:52Z","timestamp":1761897412576,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,29]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Group A streptococcus (GAS) causes a wide variety of infections in the paediatric population, ranging from pharyngitis to rare but severe invasive diseases, such as bacterial arthritis and osteomyelitis. Dental neglect is a type of child neglect in which caregivers fail to provide adequate care and treatment for dental diseases. This results in poor oral hygiene and can lead to complications including sepsis. We report the case of a 4-year-old boy, suffering from child neglect, presenting with GAS pharyngitis and subsequent bacterial arthritis in the right ankle, osteomyelitis in the right talus and abscess in the right calcaneus. He was first treated with penicillin, which was changed to clindamycin because of a suspected drug-induced rash. He was discharged after 6\u2009weeks of intravenous therapy when symptoms had resolved and inflammatory markers were within the normal range. The case highlights that dental neglect may present a risk for subsequent invasive infections.<\/jats:p>","DOI":"10.1136\/bcr-2020-239196","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:27:16Z","timestamp":1610972836000},"page":"e239196","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Paediatric case of group A streptococcal pharyngitis, arthritis and osteomyelitis associated with dental neglect"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-9069","authenticated-orcid":false,"given":"Tomohiro","family":"Hiraoka","sequence":"first","affiliation":[{"name":"Paediatrics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taro","family":"Chujo","sequence":"additional","affiliation":[{"name":"Orthopaedics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Tsuge","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Okayama University Hospital, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Paediatrics, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082800080827000_14.1.e239196.1","unstructured":"Stevens DL , Bryant AE . Severe Group A Streptococcal Infections. In: Ferretti JJ , Stevens DL , Fischetti VA , eds. Streptococcus pyogenes: basic biology to clinical manifestations [Internet]. 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