Skip to content

Advertisement

Open Access

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

https://doi.org/10.1186/cc10649

Published: 20 March 2012

Keywords

Public HealthMultivariate AnalysisSystematic ReviewPneumoniaYoung Adult

Introduction

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.

Methods

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

Results

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)

0.020

SSTI

1/13 (8%)

9/19 (47%)

0.09 (0.01 to 0.86)

0.024

Septic shock

11/11

7/15 (47%)

26.0 (1.30 to 522)

0.007

Leukocytopenia

9/11 (82%)

8/17 (47%)

5.06 (0.83 to 30.8)

0.115

Conclusion

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

Authors’ Affiliations

(1)
HUG, Geneva, Switzerland
(2)
Li Ka Shing Knowledge Institute, Toronto, Canada
(3)
CHUV, Lausanne, Switzerland

References

  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

Copyright

© 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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement