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

Abid Hussain1, Gisela Robinson2, Joanne Malkin1

  • 1Department of Clinical Microbiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK.

Journal of Medical Microbiology
|September 26, 2007
PubMed

Insights

This case study presents purpura fulminans (PF) in a child caused by Staphylococcus aureus (MSSA) with Panton-Valentine leukocidin (PVL) genes. It is the first reported UK case of MSSA-PVL infection leading to PF in a pediatric patient.

Area of Science:

  • Pediatric Infectious Diseases
  • Bacterial Pathogenesis
  • Dermatology

Background:

  • Purpura fulminans (PF) is a rare, life-threatening condition characterized by disseminated intravascular coagulation and skin necrosis.
  • Staphylococcus aureus, particularly strains encoding Panton-Valentine leukocidin (PVL), is an emerging cause of severe infections.
  • While PF secondary to Staphylococcus aureus has been reported in adults, pediatric cases are exceptionally rare.

Observation:

  • A pediatric case of purpura fulminans (PF) is described.
  • The infection was caused by meticillin-sensitive Staphylococcus aureus (MSSA) carrying the Panton-Valentine leukocidin (PVL) toxin genes.
  • This represents the first documented case of MSSA-PVL infection leading to PF in a child within the United Kingdom.

Findings:

  • Meticillin-sensitive Staphylococcus aureus (MSSA) strains encoding Panton-Valentine leukocidin (PVL) can cause severe invasive disease, including purpura fulminans (PF), in children.
  • The presence of PVL toxin genes in MSSA is a significant factor in the pathogenesis of this severe clinical manifestation.
  • This case highlights the potential for MSSA-PVL to cause critical illness in pediatric populations.

Implications:

  • Clinicians should consider Staphylococcus aureus, especially PVL-producing strains, in the differential diagnosis of purpura fulminans in children.
  • Early recognition and aggressive management are crucial for improving outcomes in pediatric PF cases.
  • This case underscores the need for further research into the epidemiology and management of PVL-positive Staphylococcus aureus infections in children.

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