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Fulminant Peritonitis Presumably Caused by Panton‐Valentine Leukocidin‐Positive Staphylococcus aureus in a Girl on Peritoneal Dialysis
Author(s) -
Battelino Nina,
Pokorn Marko,
ŠventKučitaša,
KrižanHergouth Veronika,
Novljan Gregor
Publication year - 2013
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12092
Subject(s) - medicine , panton–valentine leukocidin , peritoneal dialysis , peritonitis , fulminant , flucloxacillin , leukocidin , staphylococcus aureus , septic shock , antibiotics , vancomycin , surgery , gastroenterology , sepsis , microbiology and biotechnology , methicillin resistant staphylococcus aureus , biology , bacteria , genetics
Peritonitis is a significant complication of peritoneal dialysis ( PD ) and the most common cause of technique failure. Panton‐Valentine leukocidin ( PVL ), a cytotoxin produced by certain strains of Staphylococcus aureus ( SA ), causes destruction of neutrophils, and is associated with severe invasive infections. We present a 2.5‐year‐old girl on PD , who presented suddenly with an unusually fulminant and protracted course of peritonitis. Only a few hours after the onset of clinical signs, septic shock developed. PVL ‐positive methicillin‐sensitive SA ( MSSA ) was grown and initial empiric antibiotic treatment changed to flucloxacillin and rifampicin in order to minimize toxin production. In spite of adequate antibiotic treatment and PD ‐catheter removal, recovery was slow. No PD ‐related peritonitis in children associated with PVL ‐producing strains have been reported so far and no specific recommendation exists for treatment. We speculate that PVL contributed to the severity and outcome of peritonitis in our patient.