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Volume 14, Number 2—February 2008

Research

Severe Streptococcus pyogenes Infections, United Kingdom, 2003–2004

Theresa L. Lamagni*Comments to Author , Shona Neal*, Catherine Keshishian*, Neelam Alhaddad*, Robert C. George*, Georgia Duckworth*, Jaana Vuopio-Varkila†, and Androulla Efstratiou*
Author affiliations: *Health Protection Agency, London, United Kingdom; †National Public Health Institute, Helsinki, Finland;

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Table 2

Clinical markers of severe Streptococcus pyogenes infection in the United Kingdom, 2003–2004*

Marker All case-patients (n = 2,611), no. (%) Bacteremia with no defined focus (n = 558), no. (%) Pneumonia (n = 309), no. (%) Cellulitis (n = 881), no. (%) Septic arthritis (n = 220), no. (%) Necrotizing fasciitis (n = 136), no. (%) Puerperal sepsis (n = 58), no. (%)
Clinical severity (n = 2,611)
Hypotensive shock 494 (19) 101 (18) 70 (23) 155 (18) 43 (20) 80 (59) 13 (22)
STSS (hypotension +
>2 listed below) 196 (8) 28 (5) 27 (9) 63 (7) 18 (8) 55 (40) 3 (5)
Renal impairment 381 (15) 69 (12) 50 (16) 149 (17) 40 (18) 58 (43) 3 (5)
Respiratory distress 288 (11) 41 (7) 113 (37) 67 (8) 20 (9) 33 (24) 1 (2)
Erythematous rash 231 (9) 30 (5) 15 (5) 135 (15) 13 (6) 17 (13) 4 (7)
Soft-tissue necrosis 254 (10) 0 8 (3) 116 (13) 13 (6) 136 (100) 3 (5)
Liver abnormality 185 (7) 31 (6) 23 (7) 65 (7) 14 (6) 31 (23) 3 (5)
Disseminated
 intravascular
 coagulation 131 (5) 21 (4) 14 (5) 40 (5) 10 (5) 35 (26) 6 (10)
Admission to ICU
(n = 2,292) 451 (20) 76 (16) 68 (24) 136 (17) 40 (21) 101 (77) 8 (16)
Surgical intervention
(n = 1,885) 443 (24) 21 (6) 19 (8) 131 (20) 106 (63) 106 (87) 10 (24)
Death within 7 d
(n = 2,192) 413 (19) 97 (22) 87 (32) 121 (16) 17 (9) 43 (34) 2 (4)

*STSS, streptococcal toxic shock syndrome; ICU, intensive care unit.

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