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The spectrum of clinical disease included: pneumonia with bacteremia (two patients), osteomyelitis\/septic arthritis (three patients), epiglottitis\/supraglottitis (two patients), and sepsis without a focus (one patient). Three cases followed chicken pox. Three children were in shock at the time of presentation, including one child who had a toxic shock-like appearance. Only four children had pharyngitis. Bacteremia was confirmed in three children and presumed in another three. All the subjects survived. Four isolates of group A streptococci were tested for exotoxin A, B, and C (A-0, B-4, C-1) production. These data confirm the reappearance of a highly invasive strain of group A streptococci capable of producing a variety of clinical diseases, including bacteremia and shock, in a significant proportion of victims.<\/jats:p>","DOI":"10.1177\/000992289203101004","type":"journal-article","created":{"date-parts":[[2008,6,26]],"date-time":"2008-06-26T19:42:29Z","timestamp":1214509349000},"page":"596-601","source":"Crossref","is-referenced-by-count":17,"title":["Emergence of Invasive Group A Streptococcal Disease Among Young Children"],"prefix":"10.1177","volume":"31","author":[{"given":"William","family":"Novotny","sequence":"first","affiliation":[{"name":"Division of Critical Care"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Faden","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics State University of New York School of Medicine Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Mosovich","sequence":"additional","affiliation":[{"name":"Division of Critical Care"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1992,10,1]]},"reference":[{"key":"atypb1","unstructured":"Christie AB Streptococcal infections. 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