Open AccessEmpyema thoracis secondary to community-acquired Panton-Valentine leukocidin (PVL) methicillin-resistant Staphylococcus aureus (MRSA) infection
Author(s) -
Shahbaz Piracha,
Syeda Saba Muneer Ahmed,
Samira Mohd Afzal,
Muhammad Badar Ganaie
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228297
Subject(s) - leukocidin , medicine , panton–valentine leukocidin , staphylococcus aureus , empyema , pleural effusion , pneumonia , septic shock , methicillin resistant staphylococcus aureus , microbiology and biotechnology , surgery , sepsis , biology , bacteria , genetics
We report a case of a previously fit middle-aged man presenting to the outpatient setting with unilateral pleural effusion, with minimal symptoms. On subsequent investigations, he was diagnosed with empyema thoracis secondary to Panton-Valentine leukocidin (PVL)-toxin positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA). The patient was treated with prolonged antibiotics and pleural drainage, and he remained haemodynamically stable throughout hospital admission. PVL is a cytolytic exotoxin produced by some strains of S. aureus Such strains often cause recurrent skin and soft tissue infections, usually in previously fit and healthy individuals. Less commonly, invasive infections occur; these carry a high mortality rate if associated with necrotising pneumonia or septic shock. PVL genes are present in approximately 2% of clinical isolates of S. aureus in the UK. PVL-producing MRSA infections are on the rise and present significant clinical and public health challenges.