title: Evolution of a fatal septic arthritis caused by a Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus strain.
abstract: We report the observation of a septic arthritis of the knee complicated within first 36 hours by multiorgan failure including acute respiratory distress syndrome (ARDS), heart failure, acute renal failure and disseminated intravascular coagulation (DIC). A diagnosis of staphylococcal arthritis was suspected confirmed by direct examination, and culture showed a Staphylococcus aureus sensitive to methicillin. The sample sent to the National Reference Centre for Staphylococci (Lyon, France) for genetic analysis confirmed the isolate positive for the PVL gene expression. The fulminating evolution of a septic S. aureus arthritis in an otherwise healthy man should probably evoke the possibility of LPV strain. Anti-PLV antibiotics with anti-staphylococcal activity, such as clindamycin and linezolid should be started without waiting for typing of the S. aureus strain.
authors.affiliation: Pole of medical and surgical emergencies, Military Hospital of Instruction Mohammed V, CHU Ibn Sina, Rabat, Morocco. Electronic address: mostafarafai@hotmail.fr.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Rafai
authors.forename: Khalil
authors.initials: K
authors.lastname: Abouelalaa
authors.forename: Yassine
authors.initials: Y
authors.lastname: Skhsoukh
authors.forename: Hicham
authors.initials: H
authors.lastname: Balkhi
authors.forename: Lahcen
authors.initials: L
authors.lastname: Belyamani
authors.forename: M'barek
authors.initials: M
authors.lastname: Dimou
mesh_terms: D001170:Arthritis, Infectious / Q000150:complications / Q000382:microbiology*; D001427:Bacterial Toxins / Q000096:biosynthesis*; D005098:Exotoxins / Q000096:biosynthesis*; D006801:Humans; D007719:Knee Joint / Q000382:microbiology*; D007956:Leukocidins / Q000096:biosynthesis*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000378:metabolism*
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin
keywords: Fatal; Panton and Valentine leukocidin (PVL); Septic arthritis; Staphylococcus methi-S