Abstract The spectrum of diseases caused by Streptococcus pyogenes (Strep A) ranges from superficial to serious life-threatening invasive infections.We conducted a scoping review of published articles between 1980 and 2021 to synthesize evidence of state transitions across the Strep A disease spectrum.We identified 175 articles reporting 262 distinct observations of Strep A disease state transitions.Among the included articles, the transition from an invasive or toxin-mediated disease state to another disease state (i.e.
, to recurrent ARF, RHD or death) was described 115 times (43.9% of all included transition pairs) while the transition to and from here locally invasive category was the lowest (n = 7; 0.02%).Transitions from well to any other state was most frequently reported (49%) whereas a relatively higher number of studies cocktail tree for sale (n = 71) reported transition from invasive disease to death.Transitions from any disease state to locally invasive, Strep A pharyngitis to invasive disease, and chronic kidney disease to death were lacking.
Transitions related to severe invasive diseases were more frequently reported than superficial ones.Most evidence originated from high-income countries and there is a critical need for new studies in low- and middle-income countries to infer the state transitions across the Strep A disease spectrum in these high-burden settings.