Multifocal community-acquired necrotizing fasciitis caused by a Panton-Valentine leukocidin-producing methicillin-sensitive Staphylococcus aureus
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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.
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- Multifocal community-acquired necrotizing fasciitis caused by a Panton-Valentine leukocidin-producing methicillin-sensitive Staphylococcus aureus
Volume 38, Issue 3 , pp 223-225
- Cover Date
- Print ISSN
- Online ISSN
- Urban and Vogel
- Additional Links
- Necrotizing fasciitis
- Panton-Valentine leukocidin
- Staphylococcus aureus
- Industry Sectors
- Author Affiliations
- 1. General Intensive Care Unit, Cochin Hospital, APHP, Paris, France
- 5. Medical Intensive Care Unit, Cochin Hospital, APHP, 27, rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France
- 2. Burn Center, Cochin Hospital, APHP, Paris, France
- 3. Orthopedic Surgery, Cochin Hospital, APHP, Paris, France
- 4. French Center for Staphylococci, Lyon, France