Reasons may be that clinical presentation can
vary from asymptomatic, microscopic hematuria to
full-blown acute nephritic syndrome. We might have
we might have missed subclinical cases and ones
with microscopic hematuria [25].
Exotoxin-mediated streptococcal infections
may range from localized skin disease to scarlet fe-
ver and the rare but sometimes lethal STSS. Scarlet
fever, generally evolving from a pharyngeal focus,
develops in less than 10% of cases of GAS pharyn-
gitis. 2.6% of our patient cohort developed scarlet
fever and none developed STSS.