{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:32:41Z","timestamp":1760059961293,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Staphylococcus aureus is a significant pathogen causing both local and systemic infections in children, with deep tissue involvement leading to severe complications. This study aimed to assess clinical manifestations and identify risk factors for deep tissue involvement in pediatric S. aureus infections. Methods: All children between 1 month and 18 years who had S. aureus growth in blood, pus, or joint fluid culture were included. Results: A total of 61 patients (median age 55 months) were included, with 22.9% having deep tissue infections. Osteoarticular infections, pyomyositis, and pulmonary involvement were common. Deep-seated infections were significantly associated with community-acquired infections and positive hemocultures after 72 h (p &lt; 0.01). Laboratory results showed significantly higher levels of C-reactive protein, sedimentation rate, D-dimer, and fibrinogen in the group with deep-seated infections (p = 0.02, p = 0.018, p = 0.01, and p = 0.015, respectively). The decision tree model showed that the first indicator of deep-seated infection was a D-dimer level above 1.15 mg\/L, followed by a fibrinogen level above 334 mg\/dL. Conclusions: Deep-seated S. aureus infections are more frequently associated with community-acquired cases, persistent hemoculture positivity, and methicillin-susceptible Staphylococcus aureus (MSSA) strains. Additionally, elevated D-dimer and fibrinogen levels may serve as valuable markers for identifying deep-seated infections in pediatric patients.<\/jats:p>","DOI":"10.3390\/children12080959","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T09:47:06Z","timestamp":1753177626000},"page":"959","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating Different Clinical Manifestations of Staphylococcus\u00a0aureus Infections in Childhood\u2014Can D-Dimer and Fibrinogen Predict Deep Tissue Invasion?"],"prefix":"10.3390","volume":"12","author":[{"given":"P\u0131nar","family":"\u00d6nal","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2433-1827","authenticated-orcid":false,"given":"G\u00f6zde Apayd\u0131n","family":"Sever","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beste Akdeniz","family":"Eren","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcl\u015fen","family":"Kes","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ay\u015fe Ayz\u0131t K\u0131l\u0131n\u00e7","family":"Sakall\u0131","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonology, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6519-6583","authenticated-orcid":false,"given":"Fatih","family":"Ayg\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6khan","family":"Ayg\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Cerrahpa\u015fa Faculty of Medicine, \u0130stanbul University-Cerrahpa\u015fa, Istanbul 34098, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0086-3936","authenticated-orcid":false,"given":"Haluk","family":"\u00c7oku\u011fra\u015f","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-7155","authenticated-orcid":false,"given":"Fatma Deniz","family":"Ayg\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Cerrahpa\u015fa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34303, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1086\/528717","article-title":"Community-associated methicillin-resistant Staphylococcus aureus as a cause of healthcare-associated infection","volume":"46","author":"Boyce","year":"2008","journal-title":"Clin. 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