Doctor's Notes on Group A Strep (GAS) Infection
Group A strep (GAS), also called Streptococcus pyogenes or group A beta-hemolytic Streptococcus, is a gram-positive coccus (spherical bacteria) that is abundant, highly contagious, and spread primarily through person-to-person (skin-to-skin) contact and via respiratory droplets, as the human skin and mucous membranes are the only known reservoir for GAS. Upper respiratory tract (pharyngitis) infections and skin infections (cellulitis) with GAS are among the most common bacterial infections.
Symptoms of group A strep (GAS) tonsillopharyngitis include:
- sore throat,
- fever,
- enlarged lymph nodes in the neck,
- enlarged tonsils,
- rash,
- pus collections on the tonsils,
- tiny red spots on the palate,
- headache, and
- abdominal pain.
Symptoms of group A strep (GAS) skin diseases such as impetigo, erysipelas, and necrotizing fasciitis include:
- impetigo: blistering or infected lesion, the destruction or irritation of which results in the development of a coating described as honey crusting.
- erysipelas: skin redness, hardening, tenderness, a raised, sharply demarcated border, and a consistency often compared to that of an orange peel.
- necrotizing fasciitis: marked tissue destruction in the deep fascial layers of the skin, fever and severe pain.
What Is the Treatment for Group A Strep Infection?
Antibiotics are the treatment for invasive GAS infections as well as noninvasive group A strep infections. Although many different types of antibiotics may be adequate, it is best to determine antibiotic sensitivity of GAS bacteria in each individual case to make sure the bacteria are susceptible to the selected antibiotics.
Minor GAS infections such as strep throat or skin infections are usually treated with oral antibiotics. For severe infections, hospitalization and administration of intravenous (IV) antibiotics may be required.
Strep (Streptococcal) Throat Infection : Test Your Infectious Disease IQ Quiz

Just about any painful sore throat is caused by strep.
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Cellulitis
Cellulitis is a bacterial infection of the skin and soft tissues that causes swelling, redness, tenderness and warmth. Treatment will involve antibiotics. Severe infection may require IV or intramuscular antibiotic injections. -
Impetigo
Impetigo is a common baterial infection of the skin. The bacteria enter through a cut or other injury to the skin. Symptoms and signs include rash and/or pus-filled blisters. Treatments include oral and/or topical antibiotics. -
Necrotizing Fasciitis (Flesh-Eating Disease)
Necrotizing fasciitis is a disease caused by flesh-eating bacteria. Symptoms and signs include pain, localized redness, warmth, and swelling, along with possible fever and chills. Over hours to days, the redness spreads rapidly, and the skin may become purplish in color. Treatment of necrotizing fasciitis should begin immediately. Treatment includes antibiotics and hyperbaric oxygen therapy. -
Rheumatic Fever
The main symptom of rheumatic fever is the onset of fever 1-5 weeks after a strep throat infection. Learn more about rheumatic fever symptoms, long-term effects, and treatment. -
Strep Throat
Strep throat is a disease caused by infection with streptococcal bacteria. Strep throat is contagious. Strep throat symptoms include fever, pain, redness, and swelling of the throat and tonsils, swollen lymph nodes, white or yellow patches on the back of the throat. Treatment for strep throat includes home remedies to sooth symptoms such as throat lozenges, OTC medications, herbal teas to sooth the throat, and hydration. Medical treatment for strep throat includes antibiotics to prevent complications. -
Toxic Shock Syndrome
Toxic shock syndrome (TSS) is a rare, life-threatening illness that is caused by toxins (poisons) that circulate in the bloodstream. Symptoms and signs include fever, headache, sore throat, cough, nausea and vomiting, diarrhea, and abdominal pain. Treatment involves finding and removing the source of infection, IV antibiotics, IV fluids, correcting electrolytes, and monitoring kidney and liver functions.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.