{Reference Type}: Case Reports
{Title}: [An atypical case of necrotizing staphylococcal pneumonia].
{Author}: Bertreau E;Grard S;Baudry T;Freymond N;
{Journal}: Rev Mal Respir
{Volume}: 34
{Issue}: 9
{Year}: Nov 2017
{Factor}: 0.714
{DOI}: 10.1016/j.rmr.2017.01.006
{Abstract}: <B>BACKGROUND: </B>Some strains of Staphylococcus aureus produce a toxin known as Panton-Valentine leukocidin. These strains notably cause a necrotizing pneumonia which is associated with a high mortality.<BR><B>METHODS: </B>A 70-year-old woman presented with sub-acute onset dyspnea, low-grade fever, and hemoptysis after a trip to Dubai and New Zealand. Computed tomography showed bilateral necrotizing pneumonia, suggesting the diagnosis of pneumonia caused by S. aureus producing Panton-Valentine toxin. It was confirmed by microbiological investigation. The rapid initiation of adequate antimicrobial therapy including an effective antitoxin was essential for successful treatment, without the need for ventilatory support.<BR><B>CONCLUSIONS: </B>Necrotizing pneumonia caused by S. aureus producing Panton-Valentine leukocidin usually occurs in young subjects without comorbidities. Typical symptoms are a combination of hypoxemia, high fever, hemoptysis, leukopenia, and a rapidly worsening condition. Panton-Valentine leukocidin should not be discarded if not all the symptoms are typical. Antibiotic therapy including an antitoxin drug such as linezolid or clindamycin should be initiated promptly.