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Necrotizing pneumonia due to methicillin-sensitive Staphylococcus aureus secreting Panton-Valentine leukocidin: a review of case reports

  • L Kreienbuehl1,
  • E Charbonney2 and
  • P Eggimann3
Critical Care201216(Suppl 1):P42

Published: 20 March 2012


Public HealthMultivariate AnalysisSystematic ReviewPneumoniaYoung Adult


Community-acquired necrotizing pneumonia caused by Panton-Valentine leukocidin (PVL)-secreting Staphylococcus aureus is a highly lethal infection, which mainly affects healthy children and young adults [1, 2]. This study focuses on necrotizing pneumonia due to methicillin-sensitive S. aureus strains, with the purpose to determine factors associated with outcome.


We performed a systematic review of case reports on PVL-secreting MSSA necrotizing pneumonia and analyzed factors associated with outcome.


A total of 32 patient descriptions were retained for analysis. Septic shock, influenza-like prodrome and the absence of a previous skin and soft tissue infection were associated with fatal outcome. In multivariate analysis, influenza-like prodrome (OR 7.44; 95% CI: 1.24 to 44.76; P = 0.028) and absence of previous skin and soft tissue infection (OR 0.09; 95% CI: 0.010 to 0.86; P = 0.036) remained significant predictors of death. See Table 1.
Table 1

Univariate analysis of mortality risk factors


Died (n= 13)

Survived (n= 19)

Univariate analysis OR (95% CI)

P value

Flu-like prodrome

9/12 (75%)

4/16 (25%)

9.00 (1.60 to 50.7)



1/13 (8%)

9/19 (47%)

0.09 (0.01 to 0.86)


Septic shock


7/15 (47%)

26.0 (1.30 to 522)



9/11 (82%)

8/17 (47%)

5.06 (0.83 to 30.8)



Influenza-like prodrome may be predictive of adverse outcome and previous skin and soft tissue infection may be associated with improved prognosis.

Authors’ Affiliations

HUG, Geneva, Switzerland
Li Ka Shing Knowledge Institute, Toronto, Canada
CHUV, Lausanne, Switzerland


  1. Gillet Y, et al.: Lancet. 2002, 359: 753-759. 10.1016/S0140-6736(02)07877-7View ArticlePubMedGoogle Scholar
  2. Gillet Y, et al.: Clin Infect Dis. 2007, 45: 315-321. 10.1086/519263View ArticlePubMedGoogle Scholar


© Kreienbuehl et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.