Why Do Some Children Suffer Strep Throat Over and Over Again? Centers for Disease Control and Prevention, First Flu-COVID Combination Home Test Gets FDA Okay. Impetigo Impetigo and Ecthyma Impetigo is a superficial skin infection with crusting or bullae caused by streptococci, staphylococci, or both. There is a problem with In addition, drug-resistant S. aureus is an emerging threat. the unsubscribe link in the e-mail. Streptococci. Note the clinician has marked the border of the cellulitis with a pen, to facilitate recognition of spread or resolution. Disclaimer - Privacy Policy - Terms of Use - FAQs - Imposter Alert - Report an Imposter with high-grade or severe dysplasia.25 Staging was clas-sied according to the Union for International Cancer . A single copy of these materials may be reprinted for noncommercial personal use only. o [teenager OR adolescent ]. While anyone can get strep throat, its more common among school-aged children 5 through 15. If people have a Candida overgrowth, they may also experience the following symptoms: a headache . Our internal code of conduct adds additional privacy protection. is S.thermophilus unlikely to contribute to an overgrowth. The reason commercial tests return negatives for all the inflammation, whether vagina, prostate, uti, sore throat, anus, tongue, face etc. Please note that THE MANUAL is not responsible for the content of these resources. Accessed July 12, 2021. 2020; doi: 10.1097/AOG.0000000000003668. It made my blood sugar crash something crazy about 1-2 hrS after taking. In stool culture, commonly-isolated Gram negative and Gram positive organisms include: Gram negative: E. coli, Citrobacter, Klebsiella, Pseudomonas, Proteus, Enterobacter, and others Gram positive: Enterococcus, Streptococcus, Bacillus, Lactococcus, and others Most people with PSGN recover within a few weeks, but in rare instances long-term kidney damage, including kidney failure, can occur. One reason strep has become so rampant is because most people suffer from a zinc deficiency, and it is therefore critical to replenish your body with this vital mineral. Disease caused by other streptococcal species is less prevalent and usually involves soft-tissue infection or endocarditis (see table Lancefield Classification Lancefield Classification* *). Antibiotic treatment during labor is also recommended if you: Although it's not available yet, researchers are working on a group B strep vaccine that could help prevent group B strep infections in the future. Streptococcus spp. The GI-MAP is analyzed from a single stool sample. Streptococcus agalactiae ( S. agalactiae ), a formerly important, contagious mastitis pathogen, is now rarely observed because of continuing improvement of milking management, and as it can easily be controlled by antimicrobial treatment ( Hillerton and Berry, 2003 ). and our I haven't done any test yet but I also think I have bacterial overgrowth in the intestines, after long term use of PPIs. Choices include, Penicillin V 500 mg (250 mg for children < 27 kg) orally every 12 hours, Amoxicillin 50 mg/kg (maximum 1 g) once a day for 10 days (which is an effective substitute for penicillin V). 1996-2023 Everyday Health, Inc., a Ziff Davis company. Idk Im just walking evidence with how powerful gut health is. Mayo Clinic is a not-for-profit organization. Older adults are at increased risk of illness due to group B strep, too. This content does not have an Arabic version. https://www.uptodate.com/contents/search. Streptococcus spp. and related bacteria: Their identification and their 2010;11(6) : 1765 -8 [PubMed], -Fyderek K, Strus M, Kowalska-Duplaga K, Gosiewski T, Wedrychowicz A, Jedynak-Wasowicz U, et al. Antibiotics can be necessary and valuable in certain cases, for example a UTI that is severe and out of control. You can get sick by breathing in those droplets or by touching something that the droplets have landed on and touching your nose or mouth. other information we have about you. In adults, group B strep infection occurs less frequently than in babies, but it can affect anyone. Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Streptococcus and Haemophilus are well known as normal flora (or core microbiome), with high proportions in the human oral cavity [Citation 37-39]. The activity level of strep in the body ebbs and flows depending on the state of a persons immune system and current life circumstances. Many streptococci elaborate virulence factors, including streptolysins, DNAases, and hyaluronidase, which contribute to tissue destruction and spread of infection. People may carry GAS in these areas yet not show any symptoms of illness. Similar to acne, SIBO can arise following the frequent use of antibiotics as a young child or in adulthood. Viridans streptococci form a separate group that is difficult to classify. Streptococcus is tricky to eliminate, but liberating yourself from this bacteria is possible. Streptococcal Infections | Strep Throat | MedlinePlus If you have signs or symptoms of group B strep infection particularly if you're pregnant, you have a chronic medical condition or you're older than 65 contact your doctor right away. Learn more about the MSD Manuals and our commitment to, Practice Guidelines for the Diagnosis and Management of Group A Streptococcal Pharyngitis. It usually gets out of control as a result of taking antibiotics that kill your good bacteria. You can read more about eggs in my book Life-Changing Foods. and entroco. Diagnosis of a first episode is based on a combination of arthritis, carditis, chorea, specific cutaneous manifestations, and laboratory test results (Jones criteria see Table: Modified Jones Criteria for a First Episode of Acute Rheumatic Fever (ARF)* Modified Jones Criteria for a First Episode of Acute Rheumatic Fever (ARF)* ). The Different Types of Streptococci (Strep Bacteria) The mutaflor might did something but heard to say as I got hypothyroidism with low calcium which again gives me lots of GI issue. In the US, pneumococcal infection is a major cause of otitis media, pneumonia read more , Rheumatic Fever Rheumatic Fever Rheumatic fever is a nonsuppurative, acute inflammatory complication of group A streptococcal pharyngeal infection, causing combinations of arthritis, carditis, subcutaneous nodules, erythema read more , and Tonsillopharyngitis Tonsillopharyngitis Tonsillopharyngitis is acute infection of the pharynx, palatine tonsils, or both. However, antibiotics help prevent local suppurative complications (eg, peritonsillar abscess), otitis media, and rheumatic fever. Thus, regimens effective against both streptococci and staphylococci are used; for example, one of the following may be used: Dicloxacillin or cephalexin if methicillin-resistant Staphylococcus aureus (MRSA) is not likely, TMP/SMX, linezolid, minocycline, or clindamycin if MRSA is suspected (see treatment of cellulitis Treatment Cellulitis is acute bacterial infection of the skin and subcutaneous tissue most often caused by streptococci or staphylococci. C. difficile then causes diarrhea and can result in colitis. One of the most important reasons for treating GABHS pharyngitis (strep throat) is to prevent rheumatic fever. Penicillin given within the first 5 days for symptomatic streptococcal pharyngitis may delay the appearance and decrease the magnitude of the ASO response. paratuberculosis, Methanobacteriaceae (family), Microsporidium spp., Morganella spp., Necator americanus, Norovirus GI/II, Occult Blood - FIT, PBP1A N562Y, PBP1A S414R, PBP1A T556S, Pentatrichomonas hominis, Prevotella spp., Proteus mirabilis, Proteus spp., Pseudomonas aeruginosa, Pseudomonas spp., Rhodotorula spp., Rodotorula spp., Roseburia spp., Salmonella, Secretory IgA, Shiga-like Toxin E. coli stx1, Shiga-like Toxin E. coli stx2, Staphylococcus aureus, Staphylococcus spp., Steatocrit, Streptococcus spp., Taenia spp., Tetracycline, Trichuris trichiura, Vibrio cholerae, Virulence Factor, babA, Virulence Factor, cagA, Virulence Factor, dupA, Virulence Factor, iceA, Virulence Factor, oipA, Virulence Factor, vacA, Virulence Factor, virB, Virulence Factor, virD, Yersinia enterocolitica, Zonulin. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Antibiotic treatment of GABHS infection has little effect on development of glomerulonephritis. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Most group A strep infections cause relatively mild illness, but on rare occasions, these bacteria can lead to severe and even life-threatening disease. For most people, streptococcus first appears when they are young. Use for phrases So hoping Mutaflor helps, will take it at night now. ------------------------------------------------------------------------------------, - Relative Abundance of Streptococcus spp. 2009;15(42) : 5287 -94 [DOI] [PubMed]. In addition, delayed, nonsuppurative complications (rheumatic fever Rheumatic Fever Rheumatic fever is a nonsuppurative, acute inflammatory complication of group A streptococcal pharyngeal infection, causing combinations of arthritis, carditis, subcutaneous nodules, erythema read more , acute glomerulonephritis Postinfectious Glomerulonephritis (PIGN) Postinfectious glomerulonephritis occurs after infection, usually with a nephritogenic strain of group A beta-hemolytic streptococcus. Group A strep infections spread through direct contact with mucus from the nose or throat of infected persons or through contact with infected wounds or sores. Role of lipoteichoic acid in the phagocyte response to group B streptococcus. The rash consists of characteristic numerous small (1- to 2-mm) papular elevations, giving a sandpaper quality to the skin. Infections of the urinary tract. Although colitis is a variety of the shingles virus, it can worsen when high levels of strep in the body cause inflammation. It is also possible to get scarlet fever sores on the skin caused by GAS. Antistreptolysin O (ASO) and antideoxyribonuclease B (anti-DNase B) titers begin to increase about 1 week after the GABHS infection and peak about 1 to 2 months after the infection. Fusobacterium spp. Impetigo This is an infection of the top layers of skin that typically starts when bacteria gets into a cut, scratch, or insect bite. This area can grow sensitive to certain foods you consume and the amount of uric acid in your system. From PCOS, to breast cancer, calcifications, nodules, tumors on the thyroid, and more, eggs can exacerbate many issues, and it is best to avoid them. If the infection leads to sepsis or pneumonia, it can be fatal. Streptococcus uberis, Streptococcus dysgalactiae, Staphylococcus aureus, and Lactococcus lactis. The most significant streptococcal pathogen is S. pyogenes, which is beta-hemolytic and in Lancefield group A and is thus denoted as group A beta-hemolytic streptococci (GABHS). Antibodies are most useful in diagnosis of poststreptococcal diseases, such as rheumatic fever and glomerulonephritis. Advertising revenue supports our not-for-profit mission. Oral narrow-spectrum cephalosporins (eg, cephalexin, cefadroxil) are also effective and can be used unless patients have an anaphylactic reaction to penicillin. The fecal streptococci belong to the genera Enterococcus and Streptococcus.The genus Enterococcus includes all streptococci that share certain biochemical properties and have a wide range of tolerance of adverse growth conditions. Streptococcal Infections - Infectious Diseases - MSD Manual Raw honey contains phytochemicals that destroy all the different strep bacterias. The most significant streptococcal pathogen is S. pyogenes, which is denoted as group A beta-hemolytic streptococci (GABHS). Gelatinase and mytolysin is also produced by Viridans strep. A culture test is one way to detect streptococcus bacteria. Optimal Result: 0 - 1000 Units. All rights reserved. Other, more rare complications can affect the heart, including rheumatic fever and kidney disease. Antibiotics given to the mother during labor can help prevent the spread of the infection to the baby. Because streptococcal pharyngitis is less common among adults and adults are unlikely to have poststreptococcal complications, many clinicians do not confirm a negative rapid screening result in adults by culture unless use of a macrolide is being considered; in such cases, culture with susceptibility testing to detect macrolide resistance should be done. Streptococcus: A-to-Z Guide from Diagnosis to Treatment to Prevention Many strains ofStreptococcusare non-pathogenic and occur as commensal flora on the skin, the oral cavity, nasopharynx, upper respiratory tract, urogenital, and gastrointestinal tracts. What are Streptococcal infections? - YourGenome Streptococcus parasanguinis is a common human commensal bacterial species colonizing multiple body sites. A strawberry tongue (inflamed papillae protruding through a bright red coating) also occurs and must be differentiated from that seen in toxic shock syndrome Toxic Shock Syndrome (TSS) Toxic shock syndrome is caused by staphylococcal or streptococcal exotoxins. Puopolo KM, et al. sjb944. Strep throat may also be accompanied by headache, abdominal pain, nausea, or vomiting, especially in children. For many people, strep has been with them for most of their lives, and as people age, it tends to grow stronger and wreak greater havoc in the body. If so, what did they use. On average, 1 in 20 nonpregnant adults with an invasive strep B infection dies, the CDC reports. Does anyone have any knowledge about this? After a throat or skin infection with one of these strains, about 10 to 15% of patients develop acute glomerulonephritis. Its not menstruation or the hormones themselves that cause the worsening of symptoms, but that underlying health issues like strep can take a stronger hold during this time. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Shock and renal dysfunction are common. Group C and Group G Streptococcal Infection. Streptococci are gram-positive aerobic organisms that cause many disorders, including pharyngitis, pneumonia, wound and skin infections, sepsis, and endocarditis. Group B streptococcus, also known as group B strep or GBS, is a type of bacteria that can cause illness in people of all ages, though it can be particularly severe in newborns, most commonly causing sepsis,pneumonia, and meningitis. Prevotella copri. Group B streptococcus is a major cause of infections in newborns. Amoxicillin/clavulanate is also effective. Save time on interpreting lab results with the largest database of biomarkers online. Group B streptococcus (GBS) infection. Kill the strep and the enterococcus in your bowel and the science says you will improve. and its Association with Disease Activity in Inflammatory Bowel Disease Patients Compared with Controls [L], -Herrera P, Kwon YM, Ricke SC. If you notice any strep symptoms, adding a little goldenseal to the childs protocol can be highly beneficial. For a better experience, please enable JavaScript in your browser before proceeding. Headaches, fatigue, confusion, and low-grade fevers are some other side effects of strep in the body. Is the Tripledemic to Blame for the Rise in Serious Strep Throat Infections? , MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University; , MD, FACP, Wellington Regional Medical Center, (See also Pneumococcal Infections Pneumococcal Infections Streptococcus pneumoniae (pneumococci) are gram-positive, alpha-hemolytic, aerobic, encapsulated diplococci. Accessed July 12, 2021. Citrobacter spp. World J Gastroenterol. The information is not intended to be a substitute for professional health or Streptococcus spp. - Lab Results explained | HealthMatters.io Although strep throat is a common form of infection from streptococcal bacteria, it is not the only kind. GI Map Stool Analysis Test - DrJockers.com Cats claw, lemon balm, goldenseal, and monolaurin from coconut are four other very helpful supplements. Bananas are especially good for someone with SIBO. High levels of Strep B strain in stool might be the cause of lots of potential problems. Consult with a licensed health care practitioner before altering or discontinuing any Poststreptococcal acute glomerulonephritis Rapidly Progressive Glomerulonephritis (RPGN) Rapidly progressive glomerulonephritis is acute nephritic syndrome accompanied by microscopic glomerular crescent formation with progression to renal failure within weeks to months. Thrombosis of the microvasculature causes ischemic necrosis, leading to rapid spread and disproportionally severe toxicity. Azithromycin can be used for a 5-day course of therapy, although macrolides are inactive against Fusobacterium necrophorum, a common cause of pharyngitis in adolescents and adults. This bacterium is normally found in the intestine in small amounts. What Is Strep Throat? Try to stay away from corn, wheat, barley, rye, and canola oil. Group B strep (streptococcus) is a common bacterium often carried in the intestines or lower genital tract. . It doesn't mean that you're ill or that your baby will be affected, but that you're at increased risk of passing the bacteria to your baby. Contrary to these results reduction ofStreptococciin IBD patients were observed in studies that investigated health-beneficial effects of these bacteria. And with the gut being 1 cell thick and my wall being broken down, I wouldn't be shocked if strep and staph constantly having access to my immune system could be causing some problems. Gamma-hemolytic streptococci are nonhemolytic. Its important to stay on top of any signs of strep a child exhibits so proper supplementation can help support the childs health and antibiotics may not have to be used as frequently. Zinc sulfate is a critical strep-fighting supplement. But how can we be sure we are belting down just Strep/Enterococcus with olive leaf or whatever we are taking? Unlike streptococcal species, enterococci are relatively resistant to penicillin, with minimum inhibitory concentrations (MICs) that generally range from 1-8 mcg/mL for E faecalis and 16-64 mcg/mL for E faecium. Most viridans streptococci are susceptible to penicillin G and other beta-lactams. Symptoms of necrotizing fasciitis begin with fever and exquisite localized pain out of proportion to physical findings; pain increases rapidly over time and is often the first (and sometimes only) manifestation. health information, we will treat all of that information as protected health Once scar tissue forms on the bladder lining, inflammation and swelling might occur. To provide you with the most relevant and helpful information, and understand which Any strep symptoms will most likely worsen during or around a womans menstrual cycle when her reproductive system needs additional energy or during ovulation when hormones are shifting. There are hundreds of strep strains, some stronger than others, which can be passed between people and picked up in different environments. PLoS One. Mucosal bacterial microflora and mucus layer thickness in adolescents with inflammatory bowel disease. Manifestations of Streptococcal Cellulitis. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. 1 The condition is associated with chronic digestive problems such as gas and bloating. Parents are rarely given the information they need on how best to support their childrens health, primarily because there is so much misinformation competing for our attention today. The sources of disease caused by GBS in adults are unknown, but the bacteria are present in both the gastrointestinal and genitourinary tracts, and may be the source of infection. At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. If you're a healthy adult, there's nothing you need to do about group B strep. The rash usually lasts 2 to 5 days. If people continue to believe the faulty idea that sinus infections are attributable to pollen in the air, people will remain unwell. For more information, please see our Antibiotics shorten the course in young children, especially those with scarlet fever, but have only modest effect on symptoms in adolescents and adults. Fortunately, by cleaning up the diet, adopting a proper supplementation protocol, and building up the immune system, you can free yourself from acne and the underlying strep. Two of them cause most of the strep infections in people: group A and group B. Strep throat - a sore, red throat. 2014;8(7) : 1403 -17 [DOI] [PubMed], -Henneke P, Morath S, Uematsu S, Weichert S, Pfitzenmaier M, Takeuchi O, et al. These are local or regional variations on this beneficial herb.). It's an anti-strep food and exceptional to include for your health. Stool test showed high Streptococcus, Staphylococcus aureus, Bacillus spp., and much more. PANDAS syndrome (pediatric autoimmune neuropsychiatric disorder associated with group A streptococci) refers to a subset of obsessive disorders or tic disorders in children that is thought to be exacerbated by GABHS infection. Certain forms of psoriasis Psoriasis Psoriasis is an inflammatory disease that manifests most commonly as well-circumscribed, erythematous papules and plaques covered with silvery scales. If doctors tell patients cystic acne is just hormonal pimples, then people will remain sick and grossly misinformed. (See also the Infectious Diseases Society of Americas Practice Guidelines for the Diagnosis and Management of Group A Streptococcal Pharyngitis and the American Heart Association's guidelinePreventing Rheumatic Fever.). Taking oral antibiotics ahead of time won't help because the bacteria can return before labor begins. Mycobacterium avium. a white, yellow, or light brown string-like substance. If you're allergic to penicillin or related drugs, you might receive clindamycin or vancomycin as an alternative. Impetigo is contagious and can be spread by contact with sores or nasal discharge of an infected person. Group B strep can spread to a baby during a vaginal delivery if the baby is exposed to or swallows fluids containing group B strep. This photo shows the focal redness and swelling of the lower leg, usually accompanied by warmth and tenderness, characteristic of focal cellulitis. Diagnosis is clinical. They are gram-positive, nonspore-forming, catalase-negative, and nonmotile organisms. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Interaction of some virulence factors of Streptococci with immune cells could elicit inflammatory response in different organs. Anyone can be affected, from babies and small children to older adults. An infant is at increased risk of developing group B strep disease if: Adults age 65 and older are at increased risk of group B strep. Streptococcus overgrowth | Phoenix Rising ME/CFS Forums Ive worked with women who have experienced such terrible cystitis they could no longer function and had lost their desire to live. Illness typically manifests two to five days after exposure. A host of complications may arise that will only cease once the strep is destroyed. Alpha-hemolytic streptococci (commonly called viridans streptococci) are surrounded by green discoloration resulting from incomplete hemolysis. So any suggestions on how to heal the leaky gut aspect of CFS. Impetigo is a superficial skin infection that causes crusting or bullae. Scarlet fever is caused by group A streptococcal strains that produce an erythrogenic toxin, leading to a diffuse pink-red cutaneous flush that blanches with pressure. The fecal streptococci are a group of gram-positive Lancefield group D streptococci. It can be either non-invasive (not spread into the bloodstream) or invasive (spread into the bloodstream and to other body sites) The most common of the non-invasive infections include: strep throat: sore throat specifically caused . This site complies with the HONcode standard for trustworthy health information: verify here. Its starting to become like a superbug in its strength and pervasiveness. It is usually caused by thebacteria Staphylococcus aureus but can also be caused by group A strep. Thus, positive results can establish the diagnosis, but negative results, at least in children, should be confirmed by culture. A penicillin or cephalosporin is preferred for pharyngitis; because macrolide resistance is increasing, susceptibility testing is recommended if that class of drugs is used. These bugs are no longer opportunistic, enterococcus produce. i got streptococcus and entrococcus? Patients are usually otherwise healthy children or adults with skin and soft-tissue infections. Mayo Clinic does not endorse companies or products. (6). Your doctor will take swab samples from your vagina and rectum and send them to a lab for testing. Streptococcal Infections - Infectious Diseases - Merck Manuals The Gut: IBS, SIBO, Leaky Gut, Gastroparesis. Ecthyma is an ulcerative form of impetigo. I got CFS after gastro this year in February and never recovered from it. Clindamycin 6.7 mg/kg orally every 8 hours is preferred in children who have relapses of chronic tonsillitis, possibly because of the following: Clindamycin has good activity against penicillinase-producing staphylococci or anaerobes coinfecting the tonsillar crypts and inactivating penicillin G. It appears to halt exotoxin production more rapidly than other drugs. It is a prevalent bacteria in the oral cavity of both adults and infants (Franzosa et al., 2014; Dzidic et al., 2018), and plays an important role in dental plaque formation (Garnett et al., 2012) and significantly inhibits the growth the periodontopathogens by producing . Streptococcal pharyngitis is usually caused by GABHS. Has anyone successfully got on top of Streptococcus in the gut? Complications sometimes occur and can include abscesses around the tonsils, swollen lymph nodes in the neck, and sinus and ear infections. Some people have had past UTIs signaling strep, while others never experience UTIs, but notice different problems that might indicate cystitis and the underlying strep strain. Sore throat, headache, and fever can be treated with analgesics or antipyretics. The link you have selected will take you to a third-party website. I also got strep throat on Monday and had the OCD thoughts again. All rights reserved. Streptococcus spp. Neither Anthony William nor Anthony William, Inc. (AWI) is a licensed medical doctor or other formally Symptoms includesore throat that comes on very quickly, pain when swallowing, fever, red and swollen tonsils (sometimes with white patches or streaks of pus), small red spots on the roof of the mouth, and swollen lymph nodes in the front of the neck. The most serious cases generally occur in premature infants, babies . Streptococci infections are divided into several groups: Group A streptococcus, Group B streptococcus, Group C streptococcus, and Group G streptococcus. Note the line of redness extending up the thigh due to lymphangitis. The chance of GBS infection increases with age. Antibiotics can also help kill any strep A bacteria left in the body. Symptoms are severe sore throat, trismus, "hot potato" voice, and uvular read more . SIBO has been connected to CFS. froth or foam. Close contact with someone who has the infection is the biggest risk factor for getting the illness. The following are some English-language resources that may be useful. Staph Infection Symptoms, Causes, Natural Treatments - Dr. Axe You might want to consider trying the 28-day cleanse laid out in my first book, Medical Medium. Symptoms include otalgia, often with systemic symptoms (eg, fever read more , sinusitis Sinusitis Sinusitis is inflammation of the paranasal sinuses due to viral, bacterial, or fungal infections or allergic reactions. Citrobacter freundii. Ecology and pathogenicity of gastrointestinal Streptococcus bovis. Aspirin should be avoided in children. Sequelae of infections due to group A beta-hemolytic streptococci may include rheumatic fever and glomerulonephritis.