Infection

, Volume 38, Issue 3, pp 223–225

Multifocal community-acquired necrotizing fasciitis caused by a Panton-Valentine leukocidin-producing methicillin-sensitive Staphylococcus aureus

  • S. Perbet
  • A. Soummer
  • C. Vinsonneau
  • A. Vandebrouck
  • T. Rackelboom
  • J. Etienne
  • A. Cariou
  • J.-D. Chiche
  • J.-P. Mira
  • J. Charpentier
Case Report

DOI: 10.1007/s15010-010-0002-7

Cite this article as:
Perbet, S., Soummer, A., Vinsonneau, C. et al. Infection (2010) 38: 223. doi:10.1007/s15010-010-0002-7

Abstract

We describe a rare case of multifocal necrotizing fasciitis (NF) complicating a single vaccine injection. Injection of hepatitis B vaccine of a 16-year-old immunocompetent woman developed into rapidly spreading multifocal NF of the right arm and the thighs, with septic shock. Treatment with antimicrobial therapy and surgical debridements allowed amputation to be avoided with a favourable outcome. The etiological agent was a methicillin-sensitive Staphylococcus aureus (MSSA) isolate harboring the Panton-Valentine leukocidin (PVL) and five enterotoxins. PVL has recently been reported in large series of methicillin-resistant SA cases and has been associated with necrotizing infections. Some strains of MSSA could harbor PVL and enterotoxins. PCR investigation is not frequent but could improve the understanding of the mechanisms of lesions. This case is in keeping with the increasing incidence of MSSA harboring PVL and enterotoxins with multifocal dissemination NF and emphasizes the necessary precautions for skin decontamination before vaccine injection.

Keywords

Necrotizing fasciitisPanton-Valentine leukocidinEnterotoxinsStaphylococcus aureusVaccination

Copyright information

© Urban & Vogel 2010

Authors and Affiliations

  • S. Perbet
    • 1
    • 5
  • A. Soummer
    • 1
  • C. Vinsonneau
    • 2
  • A. Vandebrouck
    • 3
  • T. Rackelboom
    • 2
  • J. Etienne
    • 4
  • A. Cariou
    • 1
  • J.-D. Chiche
    • 1
  • J.-P. Mira
    • 1
  • J. Charpentier
    • 1
  1. 1.General Intensive Care UnitCochin Hospital, APHPParisFrance
  2. 2.Burn CenterCochin Hospital, APHPParisFrance
  3. 3.Orthopedic SurgeryCochin Hospital, APHPParisFrance
  4. 4.French Center for StaphylococciLyonFrance
  5. 5.Medical Intensive Care UnitCochin Hospital, APHPParis Cedex 14France