Necrotising Pneumonia, Staphylococcus Aureus and Panton-Valentine Leukocidin

The Panton-Valentin leukocidin (PVL) strain of meticillin-resistant Staphylococcus aureus (MRSA) is producing a new pattern of MRSA-related disease in the UK and world-wide. PVL is one of several extracellular cytotoxins produced by Staphylococcus aureus, and is usually associated with skin and soft tissue infections. PVL MRSA is uncommon in hospitals, but in the US, and now in the UK, there have been reports of severe, rapidly progressive, community-acquired haemorrhagic, necrotising pneumonia occurring in previously healthy young adults, and associated with a mortality rate of up to 75%. We review features of the pathophysiology, diagnosis and treatment of this condition, whose incidence appears to be increasing in the UK.