[Two cases of severe community-acquired pleural pneumonia due to Streptococcus pyogenes].

Introduction: The microorganisms incriminated in severe community-acquired pneumonia hospitalized in intensive care unit are the following: Streptococcus pneumoniae, enterobacteria isolated in aspiration-related pneumonia and less frequently intracellular bacteria in so-called atypical pneumonia (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila).

Case Reports: We report two cases of severe community-acquired pneumonia admitted in intensive care unit and due to Lancefield Group A beta hemolytic streptococcus (Streptococcus pyogenes). Despite the increased incidence of invasive streptococcal infections, this microorganism still has a rare causative role in the pathogenesis of community-acquired pneumonia. The case reports concern two young patients without any significant medical history and with many clinical, radiological and microbiological similarities. However, the prognosis was not the same because of the way the initial management has been provided.

Discussion: Group A beta hemolytic streptococcus could be a causative microorganism of severe and possibly fulminating community-acquired pneumonia, even in young and healthy patients as is the case with pneumococcal infections. Medical history, clinical symptoms and radiological signs should be taken into account to evoke the diagnosis and to initiate antibiotherapy early, taking into account that this microorganism is sensitive to Penicillin G.