Pediatric Musculoskeletal Infection

• DOI: 10.2106/jbjs.rvw.15.00099
• Publication Date: 2016-09-28T02:59:14Z
• Authors: Thomas J. An; Michael A. Benvenuti; Megan E. Mignemi; Isaac P. Thomsen; Jonathan G. Schoe...
• Keywords: Streptococcus Pyogenes; Panton–Valentine leukocidin; Pyomyositis; Coagulase; Lipoteichoic acid

➢ Tissue injury activates the acute-phase response mediated by liver, which promotes coagulation, immunity, and tissue regeneration. To survive disseminate, musculoskeletal pathogens express virulence factors that modulate hijack this response. As reactants required these are most abundant in damaged tissue, infections predisposed to occur tissues following traumatic or surgical injury. Staphylococcus aureus expresses coagulase von Willebrand binding protein stimulate coagulation form a fibrin abscess protects it from host immune-cell phagocytosis. After staphylococcal community reaches quorum, is colony density enables cell-to-cell communication coordinated gene expression, subsequent expression of staphylokinase stimulates activation fibrinolysis, ruptures wall results bacterial dissemination. Unlike , Streptococcus pyogenes streptokinase other activate fibrinolysis rapidly disseminate throughout body, causing diseases such as necrotizing fasciitis. Understanding strategies will help guide clinical diagnosis decision-making through monitoring markers C-reactive protein, erythrocyte sedimentation rate, fibrinogen.