Group A streptococcal infections in primary care: a case report

Abstract

Disseminated group A streptococcal disease is rarely seen in general practice, however this serious condition has a variety of presentations which are discussed. This case report follows an occult presentation in a previously fit male, with a fatal outcome. A fit 33-year-old male with no predisposing illnesses, presented to the GP on day 4 following a muscular strain. The history given was of bending over and feeling a sudden pain in the left hamstring. The pain increased over the following 3 days. There was no obvious trauma; the patient was walking with a stick. The patient had taken 60 mg of dihydrocodeine and had felt nauseated and dizzy. Physical examination of the hip and limb revealed a normal hip joint, a very tender hamstring region. There were no skin changes and movement of the knee was restricted due to hamstring pain. The working diagnosis of a hamstring strain was made and the patient was advised to take paracetamol, ibuprofen, and dihydrocodeine 30 mg four times a day. The second clinical encounter took place on day 5 at 9pm, with a …