Invasive group G streptococcal infections: A review of 37 cases

Background. Beta-hemolytic streptococci group A, B, and D which cause many diseases have been well studied. Infection caused by group G Streptococcus has increased in clinical significance, and thus is attracting more physicians' attention. This retrospective analysis reports clinical experience with such infections at the Veterans General Hospital-Taipei. Methods. Medical records of invasive Group G streptococcal isolates from March 1991 to April 1994 were reviewed. Thirty-seven cases were included. Results. There were 33 males and 4 females with a mean age of 67.4. Major underlying diseases included diabetes (24.3%), cardiovascular diseases (21.6%), malignancy (21.6%), bone or joint diseases (18.9%) and cirrhosis of the liver (13.5%). Only 8.1% cases had no underlying disease. The most common portal of entry was the skin (64.9%). There was a wide spectrum of clinical manifestations, including cellulitis (32.4%), arthritis or osteomyelitis (16.2%), endocarditis (8.1%), meningitis (8.1%), peritonitis (8.1%), empyema (5.4%) and primary bacteremia (27%). All of these isolates were susceptible to penicillin, oxacillin, cefazolin, clindamycin and vancomycin. Ten patients died, and five of these expired from group G streptococcal infections. Conclusions. Group G Streptococcus is a low virulent microorganism. Clinical improvement after therapy is fast. Poor response to antibiotics should prompt investigation of the underlying diseases or undrained foci of infection.