Pathogenesis of Cellulitis

• infectious bacterium invades a vulnerable area

(such as an open wound)
• S. aureus and S. pyogenes are the most
common pathogens responsible cellulitis
• it intrinsic constituents (M protein, Lipoteichoic
a., Protein F, Hyaluronic a.) overcomes the
defensive cells in our body, which includes mast
cells, eosinophils, basophils, and neutrophils
 Virulence factors of Group A
streptococci include:
• M protein, fibronectin-binding protein (Protein F)
and lipoteichoic acid for adherence
• hyaluronic acid capsule as an immunological
disguise and to inhibit phagocytosis
• M-protein to inhibit phagocytosis
• invasins such as streptokinase, streptodornase
(DNase B), hyaluronidase, and streptolysins
• exotoxins (SPEs), such as pyrogenic
(erythrogenic) toxin which causes the rash of
scarlet fever and systemic toxic shock syndrome.
 Superantigen: SPEs
• Cause pathogenic effects on the host
(pyrogenicity, cytotoxicity & susceptibility to
endotoxin)
• Superantigen bind to MHC-II of T-cells directly
cause activation of T-cells & other cell type (20-
30%) & release of cytokines & chemokines
• IL-1βfever; TNF-α & βcapillary leakage
hypotension & lymphoedema; IL-γ & IL-
2typical rash; IL-1skeletal muscle proteolysis