The grampositive bacterium S. pyogenes (beta-haemolytic group A Streptococcus) 
is a natural colonizer of the human oropharynx mucous membrane and one of the 
most common agents of infectious diseases in humans. S. pyogenes causes the 
widest range of disease in humans among all bacterial pathogens. It is 
responsible for various skin infections such as impetigo contagiosa and 
erysipelas, and localized mucous membrane infections of the oropharynx (e. g. 
tonsillitis and pharyngitis). Betahaemolytic group A Streptococcus causes also 
invasive diseases such as sepses including puerperal sepsis. Additionally, S. 
pyogenes induces toxin-mediated syndromes, i. e. scarlet fever, streptococcal 
toxic shock syndrome (STSS) and necrotizing fasciitis (NF). STSS and NF are 
severe, frequently fatal diseases that have emerged in Europe and Northern 
America during the last two decades. Finally, some immunpathological diseases 
such as acute rheumatic fever and glomerulonephritis also result from S. 
pyogenes infections. Most scientists recommend penicillins (benzylpenicillin, 
phenoxymethylpenicllin) as drugs of first choice for treatment of Streptococcus 
tonsillopharyngitis and scarlet fever. Erysipelas and some other skin infections 
should be treated with benzylpenicillin. Intensive care measurements are needed 
for treatment of severe toxin-mediated S. pyogenes diseases. These measurements 
include the elimination of internal bacterial foci, concomitant application of 
clindamycin and benzylpenicillin and suitable treatment of shock symptoms. 
Management of immunpathological diseases requires antiphlogistical therapy. 
Because of the wide distribution of S. pyogenes in the general population and 
the lack of an effective vaccine, possibilities for prevention allowing a 
suitable protection for diseases due to S. pyogenes are very limited.