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| | Medmicro Chapter 13 |
 | | The hyaluronic acid outer surface of S pyogenes is only weakly antigenic; however, protective immunity results from the development of type-specific antibody to the M protein of the fimbriae, which protrude from the cell wall through the capsular structure. |
 | | In children, invasive disease with S pyogenes may follow varicella, or be associated with burns or malignancy; in adults with surgical or nonsurgical wounds or underlying medical problems, i.e., diabetes, cirrhosis, underlying peripheral vascular disease, or malignancy. |
 | | For S pyogenes, it is critical to determine rheumatogenic and nephritogenic strains to limit the required multivalency of the vaccines. |
| gsbs.utmb.edu /microbook/ch013.htm (7715 words) |
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