• Lancefield Groups A, B, C and G produce and elaborate extracellular products that cause local and systemic manifestations of disease. Among these products are:

  • streptolysins S and O which damage cell membranes resulting in hemolysis.

  • streptokinase

  • DNases

  • proteases

  • pyrogenic exotoxins A,B, & C.

•  Pyrogenic exotoxins (erythrogenic toxins) cause the rash of scarlet fever

•  Pyrogenic exotoxin-producing strains of group A Streptococcus can cause necrotizing faciitis and a systemic syndrome: streptococcal toxic shock-like syndrome.

Wessels, M.R., Streptococcal and Enterococcal Infections, In Harrison's Principles of Internal Medicine 14th edition, (Isselbacher, K.J., Braunwald, E., Wilson, J.D., Martin, J.B., Fauci, A.S. and Kasper, D.L., eds) McGraw-Hill, Inc (Health Professions Division), 1998, p. 886..