We describe a case of group A beta-hemolytic streptococcal bacteremia in an individual infected with the human immunodeficiency virus (HIV). The organism was also recovered from the stool, but not from the throat. A review of 19 cases of group A beta-hemolytic streptococcal bacteremia shows an association between an underlying immunologic defect and the occurrence of serious group A beta-hemolytic streptococcal infection in adults. We review evidence in the literature suggesting that there is a predisposition to infection caused by pyogenic bacteria in HIV-infected individuals.