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PVL Staphylococcus aureus osteomyelitis complicating septic arthritis in a UK soldier serving in Iraq

J G Penn-Barwell1, S Finnikin, I Sargeant

  • 1Selly Oak Hospital, Raddlebarn Road, Selly Oak, Birmingham B29 6JD. Jowan@doctors.net.uk

Journal of the Royal Army Medical Corps
|April 20, 2010
PubMed

Insights

The first adult case of Panton-Valentine Leukocidin (PVL) secreting Staphylococcus aureus musculoskeletal infection occurred in a soldier. Military clinicians should consider PVL testing for severe S. aureus bone and joint infections.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Panton-Valentine Leukocidin (PVL) is a toxin produced by some Staphylococcus aureus strains.
  • PVL-producing S. aureus has been linked to musculoskeletal infections in pediatric and adolescent populations.

Observation:

  • This report details the first documented adult case of PVL-secreting S. aureus causing musculoskeletal infection.
  • A 26-year-old British Army soldier presented with septic arthritis, followed by femoral osteomyelitis.
  • The causative S. aureus strain isolated from tissue biopsy was confirmed to encode the PVL gene.

Findings:

  • The soldier experienced recurrent, severe musculoskeletal infections requiring surgical intervention and prolonged antibiotic treatment.
  • While S. aureus colonization rates may be higher in soldiers, PVL gene prevalence is similar to the general UK population.
  • Soldiers possess risk factors that may increase susceptibility to PVL-secreting S. aureus infections.

Implications:

  • Military healthcare providers must be aware of the potential for PVL-secreting S. aureus in aggressive musculoskeletal infections.
  • A low threshold for specific PVL testing is recommended for military personnel presenting with severe S. aureus bone and joint infections.
  • This case highlights the need for vigilance regarding PVL-producing S. aureus in adult military populations.

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