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It is also responsible for more serious diseases such as necrotozing fasciitis, Toxic shock syndrome, scarlet fever, and rheumatic fever. GAS usually causes intense local inflammation and damage, while toxins it produces can also cause systemic effects.
Asymptomatic colonization of the pharynx and skin is very common, occurring in up to 20% of school-age children. Good personal hygeine decreases skin colonization, but prevention is difficult due to its prevalence. It is predominantly beta hemolytic, meaning it leads to areas of clear lysis on blood agar plates. Spread often occurs from asymptomatic carriers, and can be via respiratory droplets and skin-to-skin. Pharyngeal infections occur through bacterial adhesins (lipoteichoic acid, protein F) binding to pharygeal fibronectin.

Rheumatic fever is a multisystem inflammatory disease occuring in the weeks after GAS infection.
The main reason to quickly treat GAS infection, with a full course, is to prevent the development of rheumatic fever.
Rheumatic fever can worsen with future infections by GAS; as a result, people are often given prophylactic antibiotics (penicillin) for many years in patients with this condition. Feel free to use and share this material as widely as possible, according to our Creative Commons license.
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He visits the doctor two days later and is prescribed a ten course of antiobiotics, but starts feeling better after three days and stops taking the drugs. Disease is most common in preschool-age children, causing pharyngitis and skin infections (pyoderma). Erythromycin, other macrolides, or an oral cephalosporin are used in patients with penicillin allergy.

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Particularly effective enzymes lead to organisms responsible for necrotizing fasciitis and myositis.
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