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More than just a simple abscess: could it be caused by Panton–Valentine leukocidin positive Staphylococcus aureus?

Published online by Cambridge University Press:  10 October 2011

J Manara*
Affiliation:
Department of ENT, Arrowe Park Hospital, Wirral, UK
P Shears
Affiliation:
Department of Microbiology, Arrowe Park Hospital, Wirral, UK
*
Address for correspondence: Dr Jonathan Manara, Department of ENT, Arrowe Park Hospital, Upton, Wirral CH49 5PE, UK E-mail: jonathanmanara@doctors.org.uk

Abstract

Objective:

A 33-year-old woman presented with a three-day history of an abscess in the left alar region, four weeks after drainage of a breast abscess. The later infection was confirmed to be due to Panton–Valentine leukocidin positive, methicillin-resistant Staphylococcus aureus. This report aims to raise awareness of such infections, and to advise when Panton–Valentine leukocidin toxin testing is appropriate.

Method:

Case report and discussion.

Results:

Although superficial Panton–Valentine leukocidin positive Staphylococcus aureus infections are relatively benign, more serious infections can be potentially life-threatening. Clinicians should be able to identify the features of potential Panton–Valentine leukocidin positive Staphylococcus aureus infection, in order to implement appropriate therapy.

Conclusion:

Clinicians need to be aware of Panton–Valentine leukocidin positive Staphylococcus aureus infections, and should ask specific questions when investigating the clinical history of patients with recurrent abscesses, as this bacterial strain is not routinely assessed by microbiology departments. If such an infection is suspected, clinicians should be aware of local protocols regarding toxin testing, antibiotic choice and decolonisation agents.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Holmes, A, Ganner, M, McGuane, S, Pitt, TL, Cookson, BD, Kearns, AM. Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J Clin Microbiol 2005;43:2384–90CrossRefGoogle ScholarPubMed
2McGrath, B, Rutledge, F, Broadfield, E. Necrotising pneumonia, Staphylococcus aureus and Panton-Valentine leukocidin. JICS 2008;9:170–2Google Scholar
3Morgan, M. Staphylococcus aureus, Panton-Valentine leukocidin, and necrotising pneumonia. BMJ 2005;331:793–4Google Scholar
4Hawkes, M, Barton, M, Conly, J, Nicolle, L, Barry, C, Ford-Jones, EL. Community associated MRSA: superbug at our doorstep. CMAJ 2007;176:54–6CrossRefGoogle ScholarPubMed
5Anonymous, . PVL-SA infections in England and Wales: 2005–2008 data and revised algorithm for referral of suspected cases. Health Protection Agency News Archives 2009;3:13Google Scholar
6McCartney, C, Cookson, B, Dance, D, Day, C, Duerden, B, Elston, T et al. Interim Guidance on Diagnosis and Management of PVL-associated Staphylococcal Infections in the UK. In:http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/AboutUs/MinistersAndDepartmentLeaders/ChiefMedicalOfficer/Features/DH_4133761 [Accessed 25 January 2011]Google Scholar
7Anonymous, . Guidance on the diagnosis and management of PVL-associated Staphylococcus aureus infections (PVL-SA) in England. HPA 2008;2:12Google Scholar
8Coyle, EA. Targeting bacterial virulence: the role of protein synthesis inhibitors in severe infection. Pharmacotherapy 2003;5:638–42CrossRefGoogle Scholar
9McClure, JA, Conly, JM, Lau, V, Elsayed, S, Louie, T, Hutchins, W et al. Novel multiplex PCR assay for detection of the staphylococcal virulence marker Panton-Valentine leukocidin genes and simultaneous discrimination of methicillin-susceptible from -resistant staphylococci. J Clin Microbiol 2006;44:1141–4CrossRefGoogle ScholarPubMed