Necrotizing Pneumonia Caused by Panton-Valentine Leucocidin-Producing Staphylococcus aureus Originating from a Bartholin's Abscess

Abstract EN

Background.

Panton-Valentine leukocidin (PVL-)producing Staphylococcus aureus is emerging as a serious problem worldwide.

There has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people with a very high mortality associated with these strains.

Sporadic severe infectious complications after incision of Bartholin's abcesses have been described but involvement of S.

aureus is rare.

Case report.

We present a 23-year-old apparently healthy female patient without any typical predisposing findings who developed severe sepsis with necrotizing pneumonia and multiple abscesses following incision of a Bartholin's abscess.

Methicillin-sensitive S.

aureus harbouring Panton-Valentine leucocidin genes were cultured from the abscess fluid, multiple blood cultures and a postoperative wound swab.

Aggressive antibiotic therapy with flucloxacillin, rifampicin and clindamycin, drainage and intensive supportive care lead finally to recovery.

Conclusions.

S.

aureus, in particular PVL-positive strains, should be considered when a young, immunocompetent person develops a fulminant necrotizing pneumonia.

Minor infections—such as Bartholin's abscess—can precede this life-threating syndrome.

Bactericidal antistaphylococcal antibiotics are recommended for treatment, and surgical procedures may become necessary.