Purpura fulminans in a child secondary to Panton–Valentine leukocidin-producing Staphylococcus aureus

Abstract

A case of purpura fulminans (PF) in a child secondary to infection with meticillin-sensitive Staphylococcus aureus (MSSA) encoding the Panton–Valentine leukocidin (PVL) toxin genes is presented. Occasional cases of PF have been documented secondary to S. aureus infection in adults, but, to the authors' knowledge, not in children. Here the first UK case of MSSA-PVL leading to PF is presented.

Methicillin Susceptible Panton - Valentine Leukocidin Positive S. Aureus Pneumonia in a Child with Novel Influenza H1N1 Infection

“…Other case series confirm the characteristics and severity of PVL -positive infections. (7,4,5,11). The symptoms of the described patient were equal with the described features.…”

Panton–Valentine leukocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature

“…One infant received ECMO and survived. Six of the ten infants died [13,16,17,21,30,31,35,36]. There are other reports of PVL-associated S. aureus pneumonia in larger cohorts; some of which include infants [2,10,37].…”

“…There are ten reported cases of infants from the USA, Europe and Asia with PVL-positive S. aureus necrotizing pneumonia [13,16,17,21,30,31,35,36]. The mean age of infants was 8.9 months (range 1-24 months), and five had MR S. aureus (all non-multiresistant).…”

“…Community acquired, rapidly progressive, necrotizing pneumonia caused by strains carrying the Panton-Valentine leukocidin (PVL) genes in otherwise healthy children and young adults is a rare but emerging problem worldwide [13,16,17,21,30,31,35,36]. Cases of invasive life-threatening non-multiresistant methicillin-resistant (nmMR) Staphylococcus aureus infection have been reported in Australia [3,14,28].…”

Characterisation of the Virulence Factors and Genetic Types of Methicillin Susceptible Staphylococcus aureus from Patients and Healthy Individuals

“…PVL toxin (encoded by pvl gene) that causes necrotic suppurative skin lesions [24] was common among community than clinical strains. This is not surprising as pvl gene is often associated with community strains (MRSA and MSSA) and is considered as a marker for communityacquired infections [6].…”