This bacteria can cause a wide variety of skin, soft-tissue and respiratory tract infections, ranging in severity from mild to life-threatening. GAS infection may present as a mild sore throat (strep throat), but can cause many skin and soft-tissue infections, including impetigo, erysipelas and cellulitis. Under some circumstances, it results in diseases, such as scarlet fever or pneumonia.
GAS can very rarely cause extremely serious conditions, known as invasive group A Streptococcus (IGAS) infections. These include bacteremia (an infection of the bloodstream), septic arthritis, meningitis, necrotising fasciitis (a severe infection leading to death of some soft tissue below the skin), or streptococcal toxic shock (severe, progressive symptoms with low blood pressure and multi-organ failure, which can be rapidly fatal). They tend to affect the less resilient - the elderly, the very young, or people with an underlying risk factor, such as injecting-drug use, alcoholism, diabetes, immunosuppression or cancer. Rarely, patients later develop post-streptococcal complications, such as rheumatic fever or glomerulonephritis (heart and kidney disease caused by an immune reaction to the bacteria).
Distinguishing GAS from other infections can be difficult, as they have similar symptoms to other common infections. For example, a sore throat or runny nose are far more likely caused by viruses than GAS, and don't need antibiotics. Most cases are relatively mild and clear up on their own.
Strep A tests are not available through the NHS for self-testing at home. It's not uncommon for someone to have GAS bacteria on their skin, or in their nose or throat, without knowing or being unwell, but they won't need antibiotics.
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