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Infectious exanthems and unusual infections.

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disease due to group A beta-hemolytic streptococci (GABHS) can be divided into 3 categories of
disease: streptococcal toxic shock syndrome (strepTSS), necrotizing fasciitis, and other invasive GABHS
disease. Patients with strepTSS may have multiorgan failure within hours of presentation. Clindamycin and penicillin G should be used in combination for treatment of invasive GABHS
disease. The mortality rate for menstrual staphylococcal toxic shock syndrome has decreased with early recognition and treatment, and removal of hyperabsorbent tampons from the market. Kawasaki syndrome (KS) is the most common cause of acquired heart
disease in children in the U. S., and atypical forms have a higher mortality rate than typical KS. Hantavirus pulmonary syndrome is a zoonosis with an 80% mortality rate if the diagnosis is not made on first presentation and patients return to the hospital in shock. Children and adolescents with
Lyme disease have an excellent prognosis and respond well to antimicrobial therapy. Cat scratch
disease (CSD) is caused by Bartonella henselae and is transmitted by flea-infested kittens. CSD lymphadenopathy typically resolves spontaneously in 2ñ3 months; however, there is a 50% likelihood of resolution in 1 month if patients receive a 5-day treatment course with azithromycin.

Adolesc Med. 2000 Jun;11(2):327-58. Review

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