A case report: septic shock due to (tropical) pyomyositis and multiple metastatic embolisms caused by Panton Valentine Leukocidin-positive methicillin-sensitive staphylococcus aureus in a 12-year-old boy
Autor: | Kristien Van Vaerenbergh, Valérie Vanbiervliet, Ignace Demeyer, Filip Claus |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Methicillin-Resistant Staphylococcus aureus Pediatrics medicine.medical_specialty Staphylococcus aureus Pyomyositis Adolescent Embolism medicine.disease_cause 03 medical and health sciences Methicillin Young Adult 0302 clinical medicine Leukocidins Medicine Humans Medical history 030212 general & internal medicine Child business.industry Septic shock Osteomyelitis General Medicine Emergency department Staphylococcal Infections bacterial infections and mycoses medicine.disease Shock Septic Blunt trauma 030220 oncology & carcinogenesis Panton–Valentine leukocidin business |
Zdroj: | Acta clinica Belgica. 77(2) |
ISSN: | 2295-3337 |
Popis: | Case Report: A 12-year-old boy, of Congolese roots and without medical history, first presented to our Emergency Department 3 days after blunt trauma of the left ankle. The boy represented on two more occasions in the next 3 days due to ongoing pain. On the last occasion he presented with severe hypoglycaemia. He was diagnosed with severe septic shock, secondary to subperiosteal abscess formation / osteomyelitis of the ankle. The patient was transferred to the paediatric intensive care unit where appropriate medical care was provided, including broad-spectrum antibiotic therapy, high dose vasopressor / inotropic support, surgical debridement of abscesses and below-knee amputation.Panton Valentine Leukocidin Toxin and Pyomyositis Tropicalis: The causative organism was a methicillin-susceptible S. aureus, which upon further identification was a carrier of the PVL (Panton Valentine leukocidin) toxin. This pathogen is responsible for severe musculoskeletal infections. In children these infections are often associated with more severe clinical course requiring a higher need for surgical intervention and longer hospital stay.Tropical pyomyositis is a disease caused by Staphylococcus aureus, often seen in tropical countries, and classically presented with muscle abscesses. Young males between the ages of 10-40 years old are the most susceptible, and often present with a history of blunt trauma. Treatment generally requires a combination of an anti-staphylococcal agent, and an anti-toxic agent blocking bacterial protein-synthesis of PVL. Source control by surgical debridement also plays a major role in the treatment of PVL-infection. Despite agressive treatment, mortality still varies from 0.5% to 2%. |
Databáze: | OpenAIRE |
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