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Brief Report Possible Prevention of an Outbreak of Group A Streptococcal Infection by a Prospective Epidemiologic Approach

  • Gerald A. Denys (a1), Jane T. Palacas (a1) and A. Martin Lerner (a1)


On May 17, 1984, a 67-year-old woman with endometrial carcinoma underwent an uneventful abdominal hysterectomy. Suddenly, 18 hours later she was in septic shock, short of breath, restless and oliguric. The wound appeared intact without erythema. Intraabdominal sepsis was postulated and the patient was given full dosages of intravenous cefotaxime, metronidazole and netilmicin. At 48 hours postoperative, the abdominal wound showed areas of necrosis and the patient died. The wound, peritoneal fluid, urine and blood yielded group A (β-hemolytic streptococci (Streptococcus pyogenes). Shortly before death, intravenous penicillin had been administered. An epidemiologic study was promptly initiated.


Corresponding author

Department of Medicine, Sinai Hospital of Detroit, Detroit, MI 48235


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