{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:57:06Z","timestamp":1789095426461,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>To investigate the clinical characteristics and treatment of septic arthritis caused by <jats:italic>Streptococcus pyogenes<\/jats:italic>(<jats:italic>S. pyogenes<\/jats:italic>) in children, we retrospectively analyzed the clinical data, laboratory results, treatments and outcomes of three pediatric cases of septic arthritis caused by <jats:italic>S. pyogenes<\/jats:italic> occurring from 2016\u20132018. The three cases of septic arthritis included 1 boy and 2 girls, aged from 2\u20137 years. Two patients experienced fever, and in all three cases, the affected joints showed redness, swelling, an increased local skin temperature, tenderness and restricted limb movement. At the first visit, all three cases showed a significantly increased white blood cell count [(27.68\u201332.02)\u00d710<jats:sup>9<\/jats:sup>\/mL] and a significantly increased erythrocyte sedimentation rate (113\u2013134 mm\/h). The C-reactive protein level was significantly increased in two cases (67 mg\/L, 147.7 mg\/L) and normal in one case. The procalcitonin level was normal in 1 case, elevated in 1 case, and undetected in 1 case. <jats:italic>S. pyogenes<\/jats:italic> isolated from cases 1 and 2 were <jats:italic>emm<\/jats:italic>1\/ST28 and from case 3 was <jats:italic>emm<\/jats:italic>12\/ST36. All patients were treated by abscess incision and drainage, and <jats:italic>S. pyogenes<\/jats:italic> was cultured in the abscess puncture fluid. All patients were treated with intravenous antibiotics after admission, and all patients were cured and discharged. The patients were followed up for 2 months, and their condition was improved and stable. No sequelae such as heart and kidney damage were detected. In conclusion, for children with septic arthritis, early diagnosis and timely treatment with incision and drainage followed by culture of the abscess puncture fluid are important. Once <jats:italic>S. pyogenes<\/jats:italic> infection is confirmed, \u03b2-lactam antibiotics provide effective treatment, avoiding use of broad-spectrum antibiotics.<\/jats:p>","DOI":"10.3389\/fcimb.2022.1117217","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T05:06:15Z","timestamp":1674018375000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Case Report: Septic arthritis in children caused by Streptococcus pyogenes\u2013rational use of antibiotics"],"prefix":"10.3389","volume":"12","author":[{"given":"Dingle","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waiwai","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danchun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejie","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.medmal.2019.07.016","article-title":"Assessing the management of pediatric bone and joint infections according to French guidelines","volume":"50","author":"Brehin","year":"2020","journal-title":"Med. Maladies Infection"},{"key":"B2","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1097\/01.qai.0000246035.86135.c0","article-title":"Resistance to erythromycin and rising penicillin MIC in Streptococcus pyogenes in India","volume":"59","author":"Capoor","year":"2006","journal-title":"Jpn J. Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.resmic.2017.09.002","article-title":"Assessment of cpa, Scl1 and Scl2 in clinical group a Streptococcus isolates and patients from north India: an evaluation of the host pathogen interaction","volume":"169","author":"Chaudhary","year":"2018","journal-title":"Res. Microbiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3969\/j.issn.1673-5501.2013.02.002","article-title":"Diagnostic value of procalcitonin and c-reactive protein as markers of systemic and localized bacterial infections","volume":"8","author":"Chen","year":"2013","journal-title":"Chin. J. Evidence Based Pediatr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/j.jbspin.2020.07.012","article-title":"2020 French recommendations on the management of septic arthritis in an adult native joint","volume":"87","author":"Couderc","year":"2020","journal-title":"Joint Bone Spine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1824","DOI":"10.3201\/eid2510.181695","article-title":"Case studies and literature review of pneumococcal septic arthritis in adults","volume":"25","author":"Dernoncourt","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"481","DOI":"10.4103\/ijmm.IJMM_20_257","article-title":"Streptococcus dysgalactiae septic arthritis of sternoclavicular joint with bacteraemia","volume":"38","author":"Dhekane","year":"2020","journal-title":"Indian J. Med. Microbiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.annemergmed.2009.06.511","article-title":"How common is MRSA in adult septic arthritis","volume":"54","author":"Frazee","year":"2009","journal-title":"Ann. Emerg. Med."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00204","article-title":"Invasive Streptococcus pyogenes infections in <3-month-old infants in France: clinical and laboratory features","volume":"8204","author":"Germont","year":"2020","journal-title":"Front. Pediatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1093\/clinids\/22.2.394","article-title":"Septic arthritis due to local spread of necrotizing fasciitis caused by Streptococcus pyogenes","volume":"22","author":"Gonz\u00e1lez-Ruiz","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"4418","DOI":"10.11816\/cn.ni.2015\u2010150987","article-title":"Clinical study of pyogenic arthritis caused by Staphylococcus aureus infection","volume":"25","author":"Jin","year":"2015","journal-title":"Chin. J. Nosocomiol"},{"key":"B12","first-page":"482","article-title":"Pitfalls in diagnosing septic arthritis in Hong Kong children: ten years' experience","volume":"18","author":"Kuong","year":"2012","journal-title":"Hong Kong Med. J."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000022938","article-title":"Medical management of septic arthritis of sternoclavicular joint","volume":"99","author":"Kwon","year":"2020","journal-title":"Med. (Baltimore)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1128\/jcm.01205-09","article-title":"Clinical and microbial characteristics of invasive Streptococcus pyogenes disease in new caledonia, a region in Oceania with a high incidence of acute rheumatic fever","volume":"48","author":"Le Hello","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.ejim.2006.05.007","article-title":"Polyarticular septic arthritis caused by Streptococcus pyogenes in an immunocompetent woman","volume":"18","author":"Marti","year":"2007","journal-title":"Eur. J. Intern. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.micinf.2006.11.014","article-title":"Variations in the distribution of genes encoding virulence and extracellular proteins in group a Streptococcus are largely restricted to 11 genomic loci","volume":"9","author":"McMillan","year":"2007","journal-title":"Microbes Infection"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e01993","DOI":"10.1128\/JCM.01993-19","article-title":"Reduced in vitro susceptibility of Streptococcus pyogenes to beta-lactam antibiotics associated with mutations in the pbp2x gene is geographically widespread","volume":"58","author":"Musser","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/j.1574-6968.2011.02252.x","article-title":"Epidemiological characterization of Streptococcus pyogenes isolated from patients with multiple onsets of pharyngitis","volume":"318","author":"Ogawa","year":"2011","journal-title":"FEMS Microbiol. Lett."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1086\/597582","article-title":"Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short-term course of parenteral therapy, for childhood septic arthritis","volume":"48","author":"Peltola","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e00374","DOI":"10.1128\/IAI.00374-17","article-title":"Incremental contributions of FbaA and other impetigo-associated surface proteins to fitness and virulence of a classical group a streptococcal skin strain","volume":"85","author":"Rouchon","year":"2017","journal-title":"Infect. Immun."},{"key":"B21","doi-asserted-by":"publisher","first-page":"101494","DOI":"10.7326\/0003-4819-101-4-494","article-title":"An outbreak of Streptococcus pyogenes infections in a nursing home","author":"Ruben","year":"1984","journal-title":"Ann. Intern. Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2176","DOI":"10.1093\/rheumatology\/kew323","article-title":"A population study of the reported incidence of native joint septic arthritis in the united kingdom between 1998 and 2013","volume":"55","author":"Rutherford","year":"2016","journal-title":"Rheumatology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1097\/INF.0000000000002471","article-title":"Molecular characterization of Streptococcus pyogenes causing invasive disease in pediatric population in Spain a 12-year study","volume":"38","author":"Sanchez-Encinales","year":"2019","journal-title":"Pediatr. Infect. Dis. J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.7860\/jcdr\/2013\/4852.3034","article-title":"Septic arthritis caused by group a Streptococcus in newborn: an unusual presentation","volume":"7","author":"Umadevi","year":"2013","journal-title":"J. Clin. Diagn. Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1111\/jpc.15716","article-title":"Microbiology of septic arthritis in young Auckland children","volume":"58","author":"van den Boom","year":"2021","journal-title":"J. Paediatr. Child Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1093\/cid\/ciz1000","article-title":"Streptococcus pyogenes pbp2x mutation confers reduced susceptibility to \u03b2-lactam antibiotics","volume":"71","author":"Vannice","year":"2020","journal-title":"Clin Infec. Dis."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.579475","article-title":"Inflammatory joint disease is a risk factor for streptococcal sepsis and septic arthritis in mice","volume":"11579475","author":"Volzke","year":"2020","journal-title":"Front. Immunol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"3646","DOI":"10.13820\/j.cnki.gdyx.2014.23.015","article-title":"Significance of serumprocalcitonin for discrimination between adult septic and aseptic arthritis","volume":"35","author":"Wang","year":"2014","journal-title":"Guangdong Med. J."},{"key":"B29","first-page":"41","article-title":"Septic arthritis in children: relationship of causative pathogens, complications, and outcome","volume":"36","author":"Wang","year":"2003","journal-title":"J. Microbiol. Immunol. Infection"},{"key":"B30","doi-asserted-by":"publisher","first-page":"4664","DOI":"10.11816\/cn.ni.2015-150840","article-title":"Diagnosis value of joint detection of serum procalcitonin,erythrocyte sedimentation rate,C-reactive protein for suppurative arthritis","volume":"25","author":"Wei","year":"2015","journal-title":"Chin. J. Nosocomiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"582","DOI":"10.3760\/cma.J.issn.0253-3006.2016.08.006","article-title":"Treatment strategies for septic arthritis with a neonatal onset","volume":"37","author":"Xu","year":"2016","journal-title":"Chin. J. Pedia Surg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1111\/jpc.15654","article-title":"Changing aetiology of paediatric septic arthritis","volume":"57","author":"Yagupsky","year":"2021","journal-title":"J.Paediatr. Child Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.2147\/IDR.S261975","article-title":"Is there emergence of \u03b2-lactam antibiotic-resistant Streptococcus pyogenes in China","volume":"13","author":"Yu","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"B34","doi-asserted-by":"publisher","first-page":"981","DOI":"10.12138\/j.issn.1671--9638.20194506","article-title":"A case of purulent arthritis complicated with sepsis caused by haemophilus influenzae type b","volume":"18","author":"Zhang","year":"2019","journal-title":"Chin. J. Infect. Contr"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1117217\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T05:06:25Z","timestamp":1674018385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1117217\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":34,"alternative-id":["10.3389\/fcimb.2022.1117217"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.1117217","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]},"article-number":"1117217"}}