The online version of this article (doi:10.1186/1752-1947-6-202) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
CD was the major contributor in writing the manuscript. AR drafted and critically revised the manuscript. TZ realized the interpretation of the radiological materials. LL drafted and critically revised the manuscript. DD operated on our patient and critically revised the manuscript. DCG operated on our patient and critically revised the manuscript. DFV contributed toward the study by preparing the photographs, by revising the manuscript and by performing the editorial work. All authors read and approved the final manuscript.
Strains of Panton-Valentine leukocidin-producing Staphylococcus aureus producing a new pattern of disease have emerged worldwide. Infection with these bacteria typically presents as a life-threatening infection of soft tissues and bones, and may cause potentially devastating consequences.
We report a case of osteoarticular infection caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. A 12-year-old Caucasian girl presented with acute osteomyelitis of the tibia associated with toxic shock syndrome, which was complicated by an unexpected spontaneous ankle arthrodesis.
Osteoarticular infections due to Panton-Valentine leukocidin-producing Staphylococcus aureus appear to be severe, and are characterized by their tendency to evolve towards serious complications. This case highlights the need for early and aggressive surgical procedures in conjunction with appropriate antimicrobial therapy and regular long-term follow-up.
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Panton P, Valentine F: Staphylococcal toxin. Lancet. 1932, 1: 506-508. CrossRef
Genestier AL, Michallet MC, Prevost G, Bellot G, Chalabreysse L, Peyrol S, Thivolet F, Etienne J, Lina G, Vallette FM, Vandenesch F, Genestier L: Staphylococcus aureus Panton-Valentine leukocidin directly targets mitochondria and induces Bax-independent apoptosis of human neutrophils. J Clin Invest. 2005, 115: 3117-3127. 10.1172/JCI22684. CrossRefPubMedPubMedCentral
Bocchini CE, Hulten KG, Mason EO, Gonzalez BE, Hammerman WA, Kaplan SL: Panton-Valentine leukocidin genes are associated with enhanced inflammatory response and local disease in acute hematogenous Staphylococcus aureus osteomyelitis in children. Pediatrics. 2006, 117: 433-440. 10.1542/peds.2005-0566. CrossRefPubMed
Sdougkos G, Chini V, Papanastasiou DA, Christodoulou G, Tagaris G, Dimitracopoulos G, Spiliopoulou I: Methicillin-resistant Staphylococcus aureus producing Panton-Valentine leukocidin as a cause of acute osteomyelitis in children. Clin Microbiol Infect. 2007, 13: 651-654. 10.1111/j.1469-0691.2007.01713.x. CrossRefPubMed
Gillet Y, Issartel B, Vanhems P, Fournet JC, Lina G, Bes M, Vandenesch F, Piémont Y, Brousse N, Floret D, Etienne J: Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet. 2002, 359: 753-759. 10.1016/S0140-6736(02)07877-7. CrossRefPubMed
Holmes A, Ganner M, McGuane S, Pitt TL, Cookson BD, Kearns AM: Staphylococcus aureus isolates carrying Panton-Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J Clin Microbiol. 2005, 43: 2384-2390. 10.1128/JCM.43.5.2384-2390.2005. CrossRefPubMedPubMedCentral
Martinez-Aguilar G, Avalos-Mishaan A, Hulten K, Hammerman W, Mason EO, Kaplan SL: Community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children. Pediatr Infect Dis J. 2004, 23: 701-706. 10.1097/01.inf.0000133044.79130.2a. CrossRefPubMed
Roy S, Bhawan J: Ultrastructure of articular cartilage in pyogenic arthritis. Arch Pathol. 1975, 99: 44-47. PubMed
Smith RL, Schurman DJ, Kajiyama G, Mell M, Gilkerson E: The effect of antibiotics on the destruction of cartilage in experimental infectious arthritis. J Bone Joint Surg Am. 1987, 69: 1063-1068. PubMed
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Rebecca Anderson de la Llana
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- BioMed Central