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However, rather than being directly invasive and inflammatory, it seems to cause local infection, but then its other actions are via toxins: whether affecting kidneys in post strep glomerulonephritis, heart valves in rheumatic fever, the scarlet skin of scarlet fever or dissolving tissue in necrotizing fasciitis.
Other Streptococcus species may also possess the Group A antigen, but human infections by non-S. pyogenes GAS strains ( some S. dysgalactiae subsp.
equisimilis and S. anginosus Group strains ) appear to be uncommon.

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