title: Necrotizing pneumonia caused by Panton-Valentine leukocidin-producing methicillin-susceptible Staphylococcus aureus (MSSA).
abstract: Staphylococcus aureus harboured by Panton-Valentine leukocidin (PVL) is emerging as a serious problem worldwide.  There has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people with very high mortality rate associated with these strains. This report documents a confirmed case of necrotizing pneumonia due to methicillin-susceptible S. aureus (MSSA) harbouring Panton-Valentine leukocidin genes.  An apparently healthy 49-year old man was admitted to our hospital for dyspnea and he quickly developed acute respiratory distress syndrome. MSSA harbouring Panton-Valentine leukocidin genes were cultured from the abscess fluid and from multiple blood specimens. Aggressive antibiotic therapy was started and intensive supportive care led finally to a complete recovery. Rapid identification of Panton-Valentine leukocidin in MSSA samples should be supposed when a young, immunocompetent patient, develops a necrotizing pneumonia. Bactericidal antistaphylococcal antibiotics are recommended for the treatment as soon as possible to avoid the potentially devastating consequences of this kind of S. aureus.
authors.affiliation: Dipartimento di Emergenza e Terapia Intensiva, U.L.S.S. 2, Feltre, Belluno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Catena
authors.forename: Marco
authors.initials: M
authors.lastname: Baiocchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Lentini
authors.forename: Luigi
authors.initials: L
authors.lastname: Badolati
authors.forename: Monica
authors.initials: M
authors.lastname: Baccarin
authors.forename: Daniele D
authors.initials: DD
authors.lastname: Del Monte
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rubini
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000096:biosynthesis*; D004322:Drainage; D004359:Drug Therapy, Combination; D005098:Exotoxins / Q000096:biosynthesis*; D005500:Follow-Up Studies; D006615:Hip; D006801:Humans; D007121:Immunocompetence; D007956:Leukocidins / Q000096:biosynthesis*; D008297:Male; D008712:Methicillin / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis; D011023:Pneumonia, Staphylococcal / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D013211:Staphylococcus aureus / Q000201:enzymology* / Q000302:isolation & purification / Q000472:pathogenicity; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D008712:Methicillin