Skin infection with chronic ulceration, paronychia and wound infections also occur. Humans are the only reservoirs of infection. The incubation period is unknown. Erythromycin is the drug of choice but no prospective trials have been performed. The organism is also sensitive to clindmycin, azithromycin, ciprofloxacin and tetracycline in vitro.
Environmental spread is generally from person to person.
The organism occurs intracellularly which may account for failure of penicillin therapy. Differention from GAS with a negative rapid step antigen test is helpful and in an adolescent suggests EBV or Arcanobacterium infection.