Related Experiment Video
Updated: Feb 3, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Paediatric musculoskeletal infections with Panton-Valentine leucocidin
Maciej K Albiński1, Nicolas Lutz1, Dimitri Ceroni2
1Paediatric Trauma and Orthopaedic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Insights
Panton-Valentine leucocidin (PVL)-producing Staphylococcus aureus causes severe paediatric musculoskeletal infections with high recurrence rates. Early recognition and specialized treatment are crucial for managing these critical, rapidly progressing conditions in children.
Area of Science:
- Pediatric Infectious Diseases
- Musculoskeletal Infections
- Bacterial Pathogenesis
Background:
- Panton-Valentine leucocidin (PVL)-producing Staphylococcus aureus infections in children are rare but critical.
- These infections present with rapid inflammation, poor response to conservative therapy, and high recurrence rates.
- Understanding the clinical characteristics and outcomes of these infections is vital for effective management.
Purpose of the Study:
- To illustrate the significance of paediatric PVL-producing S. aureus musculoskeletal infections.
- To analyze the clinical presentation, laboratory findings, and treatment outcomes.
- To emphasize the importance of specialized care for these challenging pediatric cases.
Main Methods:
- Retrospective analysis of case records from University Hospitals of Lausanne and Geneva (2008-2016).
- Inclusion of children diagnosed with musculoskeletal infections caused by PVL-producing S. aureus.
- Review of clinical parameters, biological assessments, and treatment strategies.
Main Results:
- Nine cases identified: four osteomyelitis, two septic arthritis, three skin/soft tissue infections.
- PVL-producing S. aureus was predominantly methicillin-sensitive (MSSA) (8/9 cases).
- Complications included recurrent infections (5/9), pathological fracture (1/9), and growth arrest (2/9).
Conclusions:
- Paediatric PVL-producing S. aureus musculoskeletal infections are uncommon in western Switzerland.
- Despite low prevalence, these infections necessitate specialized clinical expertise due to severe complications and prolonged treatment.
- Clinicians must be well-versed in the unique aspects of these infections for optimal pediatric patient care.
Aims Of The Study:
Paediatric musculoskeletal infections by Panton-Valentine leucocidin (PVL)-producing Staphylococcus aureus constitute a rare, but highly critical event. They are characterised by a rapid course of marked inflammation, worsening under conservative therapy and a high rate of recurrence. This study aimed to illustrate the importance of paediatric PVL-producing S. aureus musculoskeletal infections in western Switzerland.
Methods:
Case records, clinical parameters and biological assessments of children with musculoskeletal infections due to PVL-producing S. aureus who attended the University Hospitals of Lausanne and Geneva from 2008 to 2016 were studied retrospectively.
Results:
Of the nine cases (seven male), four presented with haematogenous acute osteomyelitis, two with septic arthritis, and three with skin and soft tissue infections. Laboratory analysis revealed mean values for white blood cell count of 12,700/mm3, C-reactive protein (CRP) 171mg/l, erythrocyte sedimentation rate (ESR) 62 mm/h and platelet count 241,000/mm3. Notably, fever and laboratory values were higher for osteoarticular infections. PVL was produced by methicillin-sensitive S. aureus (MSSA) in eight cases and by community-acquired methicillin-resistant S. aureus (CA-MRSA) in one case. PVL was identified in blood cultures (six cases), operative samples (seven cases) and an oral swab (one case). Treatment relied on surgical procedures, endorsed by two-agent antimicrobial therapy for up to 9 weeks. Complications included recurrent infections (five cases), pathological fracture (one case) and growth arrest (two cases), as well as an important psychological impact (one case).
Conclusion:
The results of this study highlight the low prevalence of PVL-producing S. aureus musculoskeletal infections in the paediatric population in our region. Nevertheless, given the importance of complications, the recurrence rate and the duration of treatment, clinicians caring for children need to be especially well versed with the peculiarity of this entity. Retrospective case series.
Level Of Evidence:
IV.
Related Concept Videos
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
01:26Stages of Infection
01:26Defense Mechanism Against Infection
In addition, many body organ systems have unique defenses against infection. The skin is an intact, multilayered surface preventing invasion by microorganisms unless impaired. Mucous membranes lining the mouth, nose, and eyelids are barriers...
01:26Sexually Transmitted Infections
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...