To the Editor: Panton–Valentine leukocidin (PVL) is a potent necrotising toxin, which, although produced by less than 5% of all Staphylococcus aureus strains, is strongly associated with pathogenic isolates that cause recurrent furunculosis and severe necrotising pneumonia.1 The virulence of PVL-positive community-associated methicillin-resistant S. aureus (CA-MRSA) causing necrotising pneumonia was recently highlighted in the Journal.2 Conversely, PVL produced by methicillin-sensitive S. aureus (MSSA) is uncommon.1 Here, we describe a case of fulminant necrotising pneumonia caused by PVL-positive MSSA, which, to our knowledge, is the first reported case in Australia.
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- Department of Infectious Diseases, Northern Hospital, Melbourne, VIC.
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- 2. Risson DC, O’Connor ED, Guard RW, et al. A fatal case of necrotising pneumonia due to community-associated methicillin-resistant Staphylococcus aureus. Med J Aust 2007; 186: 479-480. <MJA full text>
- 3. Nimmo GR, Coombs GW, Pearson JC, et al. Methicillin-resistant Staphylococcus aureus in the Australian community: an evolving epidemic. Med J Aust 2006; 184: 384-388. <MJA full text>
- 4. Gillet Y, Vanhems P, Lina G, et al. Factors predicting mortality in necrotizing community-acquired pneumonia caused by Staphylococcus aureus containing Panton–Valentine leukocidin. Clin Infect Dis 2007; 45: 315-321.
- 5. Voyich JM, Otto M, Mathema B, et al. Is Panton–Valentine leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease? J Infect Dis 2006; 194: 1761-1770.
- 6. Swaminathan A, Massasso D, Gotis-Graham I, Gosbell I. Fulminant methicillin-sensitive Staphylococcus aureus infection in a healthy adolescent, highlighting ‘Panton–Valentine leucocidin syndrome’. Intern Med J 2006; 36: 744-747.
- 7. Gauduchon V, Cozon G, Vandenesch F, et al. Neutralization of Staphylococcus aureus Panton Valentine leukocidin by intravenous immunoglobulin in vitro. J Infect Dis 2004; 189: 346-353.