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Published on: February 23, 2014
Pleuropulmonary complications of PVL-positive Staphylococcus aureus infection in children
Biju Thomas1, Arun Pugalenthi, Mark Chilvers
1Children's Hospital, Leicester Royal Infirmary, Leicester, UK.
Insights
Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus causes severe pneumonia in children. Early recognition and treatment are crucial for managing serious lung complications from this infection.
Area of Science:
- Pediatric Infectious Diseases
- Pulmonology
- Microbiology
Background:
- Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus (PVL-SA) is linked to severe community-acquired pneumonia.
- Community-acquired methicillin-sensitive S. aureus (CA-MSSA) producing PVL toxin can cause aggressive infections.
Observation:
- Four children with CA-MSSA PVL toxin infection presented with severe pleuropulmonary complications.
- Manifestations included bilateral infiltrates, pneumatocoeles, pneumothoraces, pleural effusion, empyema, lung abscess, and diaphragmatic paralysis.
Findings:
- PVL-SA can lead to diverse and severe pleuropulmonary complications in children.
- These complications underscore the aggressive nature of PVL-SA pneumonia.
Implications:
- Heightened awareness and early recognition of PVL-SA are vital for prompt diagnosis.
- Aggressive therapeutic strategies are necessary to manage severe pleuropulmonary disease caused by PVL-SA.
Unlabelled:
It is increasingly recognized world-wide that Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus (PVL-SA) is associated with a highly aggressive and often fatal form of community-acquired pneumonia. We report four children who presented with severe pleuropulmonary complications due to infection by community-acquired methicillin-sensitive S. aureus (CA-MSSA), producing PVL toxin. The complications included bilateral multilobular infiltrates, pneumatocoeles, recurrent pneumothoraces, pleural effusion, empyema, lung abscess and diaphragmatic paralysis. This case series highlights the diverse pleuropulmonary manifestations of this potentially lethal infection and the importance of heightened awareness, early recognition and aggressive therapy.
Conclusion:
Complicated pneumonia in a previously fit young patient with a history of preceding 'flu-like' illness or skin/soft tissue infection should raise the suspicion of infection by PVL-positive Staphylococcus aureus (PVL-SA). Severe pleuropulmonary complications are a feature of this disease.
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