. 2009 Feb;15(2):216–222. doi: 10.3201/eid1502.080558

Table 1. Case definitions for invasive GAS disease, Fiji, 2005–2007*.

Disease	Case definition
Definite	Either of the following: 1. The isolation of GAS from a normally sterile site (e.g., blood, cerebrospinal fluid, or other sterile fluid/tissue). 2. Clinical presentation of necrotizing fasciitis with evidence of GAS infection (e.g., the presence of typical gram-positive cocci on Gram stain or positive streptococcal serology).
Probable	Any of the following: 1. A classic presentation of necrotizing fasciitis without microbiological confirmation. 2. Cellulitis in a patient who is moderately or severely unwell (i.e., unwell and history of parenteral antibiotics and/or admission to hospital) and microbiological confirmation (i.e., group A streptococcal culture of swab or positive streptococcal serology). 3. Other clinically significant infection in a patient who is moderately or severely unwell (i.e., unwell and history of parenteral antibiotics and/or admission to hospital), in conjunction with positive group A streptococcal culture from deep wound swab or biopsy from surgical infection site.

Disease

Case definition

Definite

Either of the following: 1. The isolation of GAS from a normally sterile site (e.g., blood, cerebrospinal fluid, or other sterile fluid/tissue). 2. Clinical presentation of necrotizing fasciitis with evidence of GAS infection (e.g., the presence of typical gram-positive cocci on Gram stain or positive streptococcal serology).

Probable

Any of the following: 1. A classic presentation of necrotizing fasciitis without microbiological confirmation. 2. Cellulitis in a patient who is moderately or severely unwell (i.e., unwell and history of parenteral antibiotics and/or admission to hospital) and microbiological confirmation (i.e., group A streptococcal culture of swab or positive streptococcal serology). 3. Other clinically significant infection in a patient who is moderately or severely unwell (i.e., unwell and history of parenteral antibiotics and/or admission to hospital), in conjunction with positive group A streptococcal culture from deep wound swab or biopsy from surgical infection site.

*GAS, group A streptococci.