Lancefield Classification*

Lancefield Group

Species

Hemolysis

Associated Diseases

Treatment

A

Streptococcus pyogenes

Beta

Pharyngitis, tonsillitis, wound and skin infections, septicemia, scarlet fever, pneumonia, rheumatic fever, glomerulonephritis, endocarditis (rare)

Penicillin

Necrotizing fasciitis

Expeditious surgical management

B

S. agalactiae

Beta

Sepsis, postpartum or neonatal sepsis, meningitis, skin infections, endocarditis, septic arthritis, urinary tract infection

C and G

S. equi, S. equimilis, S. zooepidemicus, S. canis

Beta

Pharyngitis, pneumonia, cellulitis, pyoderma, erysipelas, impetigo, wound infections, puerperal sepsis, neonatal sepsis, endocarditis, septic arthritis

Human infection with group C implies a zoonotic origin

D

Enterococcal:† Enterococcus faecalis, E. faecium

Nonenterococcal: S. gallolyticus (formerly S. bovis), S. equinus

Alpha or gamma

Endocarditis, urinary tract infection, intra-abdominal infection, cellulitis, wound infection as well as concurrent bacteremia

S. gallolyticus (formerly S. bovis biotype I)

Colonic adenomas or carcinomas, endocarditis

Viridans‡

S. mutans, S. sanguis, S. salivarius, S. mitis (formerly S. mitior), S. anginosus (formerly S milleri), S. constellatus, S. intermedius

Alpha or gamma

Endocarditis, bacteremia, meningitis, localized infection, abscesses (particularly S. anginosus)

S. suis

Meningitis, sometimes toxic shock syndrome

S. iniae

Cellulitis, invasive infections from fish

Penicillin

* This table includes only the most clinically relevant of the 20 Lancefield groups.

† Enterococci were initially included among the group D streptococci but are now classified as a separate genus even though they do express Lancefield group D antigens.

‡ Do not conform to specific Lancefield serogroups.

GABHS = group A beta-hemolytic streptococci.