Tags

Type your tag names separated by a space and hit enter

Panton-Valentine leukocidin is associated with exacerbated skin manifestations and inflammatory response in children with community-associated staphylococcal scarlet fever.
Clin Infect Dis 2009; 49(7):e69-75CI

Abstract

BACKGROUND

Staphylococcal scarlet fever (SSF), a rare disease, was first described in 1900. The clinical features and outcomes in children with SSF caused by Panton-Valentine leukocidin (PVL)-positive and PVL-negative Staphylococcus aureus strains have not been compared prospectively.

METHODS

The demographic data, selected clinical features, laboratory values, and outcomes for 49 consecutive children with community-acquired S. aureus SSF prospectively identified during an 11-year period were collected for analysis.

RESULTS

The male-to-female ratio was 1.88, and the median age of the patients was 37 months. Cutaneous abscesses predominated among children with SSF. Methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) caused SSF in 26 and 23 children, respectively. Twenty-four isolates had results that were positive for PVL (5 MSSA and 19 MRSA isolates), and 25 had results that were negative for PVL (21 MSSA and 4 MRSA isolates). Polymerase chain reaction revealed that most (92%) contained only staphylococcal enterotoxin B (23 MSSA and 22 MRSA isolates). By multivariate analysis, children with PVL-positive isolates had significantly larger abscess sizes, higher white blood cell counts, higher C-reactive protein levels, and longer durations of fever, generalized scarlatiniform rashes, and hospital stays. Most (17 isolates; 89%) of the 19 PVL-positive MRSA isolates carried the staphylococcal cassette chromosome mec V(T) and all were multilocus sequence type 59.

CONCLUSION

SSF caused by PVL-positive S. aureus strains were associated with more-exacerbated skin manifestations and a greater systemic inflammatory response, compared with those cases caused by PVL-negative S. aureus. Clinical improvement after incision and drainage was achieved for most children with SSF caused by PVL-positive MRSA strains, despite treatment with an ineffective antibiotic.

Authors+Show Affiliations

Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19725782

Citation

Lo, Wen-Tsung, et al. "Panton-Valentine Leukocidin Is Associated With Exacerbated Skin Manifestations and Inflammatory Response in Children With Community-associated Staphylococcal Scarlet Fever." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 49, no. 7, 2009, pp. e69-75.
Lo WT, Tang CS, Chen SJ, et al. Panton-Valentine leukocidin is associated with exacerbated skin manifestations and inflammatory response in children with community-associated staphylococcal scarlet fever. Clin Infect Dis. 2009;49(7):e69-75.
Lo, W. T., Tang, C. S., Chen, S. J., Huang, C. F., Tseng, M. H., & Wang, C. C. (2009). Panton-Valentine leukocidin is associated with exacerbated skin manifestations and inflammatory response in children with community-associated staphylococcal scarlet fever. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 49(7), pp. e69-75. doi:10.1086/605580.
Lo WT, et al. Panton-Valentine Leukocidin Is Associated With Exacerbated Skin Manifestations and Inflammatory Response in Children With Community-associated Staphylococcal Scarlet Fever. Clin Infect Dis. 2009 Oct 1;49(7):e69-75. PubMed PMID: 19725782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Panton-Valentine leukocidin is associated with exacerbated skin manifestations and inflammatory response in children with community-associated staphylococcal scarlet fever. AU - Lo,Wen-Tsung, AU - Tang,Ching-Shen, AU - Chen,Shyi-Jou, AU - Huang,Ching-Feng, AU - Tseng,Min-Hua, AU - Wang,Chih-Chien, PY - 2009/9/4/entrez PY - 2009/9/4/pubmed PY - 2009/11/3/medline SP - e69 EP - 75 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 49 IS - 7 N2 - BACKGROUND: Staphylococcal scarlet fever (SSF), a rare disease, was first described in 1900. The clinical features and outcomes in children with SSF caused by Panton-Valentine leukocidin (PVL)-positive and PVL-negative Staphylococcus aureus strains have not been compared prospectively. METHODS: The demographic data, selected clinical features, laboratory values, and outcomes for 49 consecutive children with community-acquired S. aureus SSF prospectively identified during an 11-year period were collected for analysis. RESULTS: The male-to-female ratio was 1.88, and the median age of the patients was 37 months. Cutaneous abscesses predominated among children with SSF. Methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) caused SSF in 26 and 23 children, respectively. Twenty-four isolates had results that were positive for PVL (5 MSSA and 19 MRSA isolates), and 25 had results that were negative for PVL (21 MSSA and 4 MRSA isolates). Polymerase chain reaction revealed that most (92%) contained only staphylococcal enterotoxin B (23 MSSA and 22 MRSA isolates). By multivariate analysis, children with PVL-positive isolates had significantly larger abscess sizes, higher white blood cell counts, higher C-reactive protein levels, and longer durations of fever, generalized scarlatiniform rashes, and hospital stays. Most (17 isolates; 89%) of the 19 PVL-positive MRSA isolates carried the staphylococcal cassette chromosome mec V(T) and all were multilocus sequence type 59. CONCLUSION: SSF caused by PVL-positive S. aureus strains were associated with more-exacerbated skin manifestations and a greater systemic inflammatory response, compared with those cases caused by PVL-negative S. aureus. Clinical improvement after incision and drainage was achieved for most children with SSF caused by PVL-positive MRSA strains, despite treatment with an ineffective antibiotic. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/19725782/Panton_Valentine_leukocidin_is_associated_with_exacerbated_skin_manifestations_and_inflammatory_response_in_children_with_community_associated_staphylococcal_scarlet_fever_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/605580 DB - PRIME DP - Unbound Medicine ER -