Primary psoas abscess caused by group A streptococcus in a child: Case report with microbiologic findings.
Primary abscess of the iliopsoas muscle in children is uncommon, especially due to Streptococcus pyogenes (group A streptococcus: GAS), which causes a variety of diseases ranging from pharyngitis to invasive life-threatening infection. We present primary iliopsoas abscess in a nine-year-old boy presenting with fever, mild disturbance of consciousness, limp, and pain in the right loin. Magnetic resonance imaging and isolation of GAS from both blood and abscess samples led us to the confirmative diagnosis. The patient recovered after treatment comprising drainage and intravenous antibiotics. The CovRS system is one of the best-characterized systems with two-component signal transduction in the GAS, and mutations in covRS induce overproduction of various virulence factors that play a crucial role in invasive GAS infection. RopB, also known as a GAS regulator, influences the expression of multiple regulatory networks to coregulate virulence factor expression in GAS. In the present case, sequence analysis revealed the isolated GAS as emm type 6 with alterations in covS, whereas the covR and ropB genes were intact. The covS alterations might have influenced the virulence of the strain causing this severe GAS infection.
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yasuko
Y
Kamiya
Department of Bacteriology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Tadao
T
Hasegawa
Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yasuhiko
Y
Takegami
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kazuhiro
K
Horiba
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Shotaro
S
Ando
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yuka
Y
Torii
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hiroyuki
H
Kidokoro
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Taichi
T
Kato
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Jun
J
Natsume
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Jun-Ich
JI
Kawada
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: yoshi-i@med.nagoya-u.ac.jp.
Yoshinori
Y
Ito
D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D006801:Humans; D008297:Male; D016659:Psoas Abscess / Q000382:microbiology*; D013290:Streptococcal Infections / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000235:genetics / Q000472:pathogenicity*; D014774:Virulence / Q000235:genetics
D001426:Bacterial Proteins
Bacteremia; Child; Group A streptococcus; Iliopsoas abscess; covRS gene