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Table 1 Summary of the reported cases of severe PLV S. aureus infections in children from 2010 to 2020

From: Panton-valentine leukocidin Staphylococcus aureus severe infection in an infant: a case report and a review of the literature

Author, Year, Nation, Reference

Patients

Age, sex

Clinical presentation

Radiological findings

Antibiotic treatment

MSSA/MRSA and genotype

Treatment antibiotic duration

Other treatment

Outcome

Esteves, 2010, Portugal [15]

1

14-years, M

Fever, cough, thoracic and right inguinal pain 10 days after a toe trauma

Bilateral pneumonia and minor pleural effusion (RX).

Deep venous thrombosis of right femoral vein (ultrasound).

Bilateral thoracic infiltrates and pleural effusion (CT).

Right hip arthritis (CT)

Intravenous piperacillin-tazobactam followed by intravenous flucloxacillin

MSSA genotype not clarified

4 weeks of intravenous flucloxacillin

Low-molecular weight heparin

Complete resolution

Erturan, 2012, United Kingdom [16]

1

16-years, M

Lethargy, loss of appetite, worsening pain of right knee. Fever. Subsequent multilobar pneumonia and pericardial effusion, septicaemia

Right proximal tibial osteomyelitis (MRI)

Intravenous fluoxacillin, which was substituted on day 9 by intravenous linezolid and daptomycin on day 11 and oral clindamycin

MSSA genotype not clarified

Intravenous linezolid 21 days, intravenous daptomycin 19 days, clindamycin 30 days (which was continued at home)

Arthroscopic washout

Complete resolution

Wangjirapan, 2012, Thailand [4]

1

8-years, M

Fever, low back pain, dyspnoea, abdomen distension with guarding and moderate tenderness, endocarditis

Paravertebral abscess, multiple consolidations in the bilateral basal lungs, pleural effusion, thrombosis inferior vena cava, left common iliac vein, proximal left internal iliac vein, small liver abscess, osteomyelitis 5th lumbar vertebral body (CT).

Intravenous cloxacillin, clindamycin and gentamicin.

MSSA

genotype not clarified

Gentamicin 14 days, cloxacilin and clindamycin 6 weeks.

Proper surgical drainages

A CT-scan at follow up demonstrated a significantly decreased lung abscess and left pleural effusion. He ambulated well and went back to school

Ceroni, 2012, Switzerland [2]

1

12-years, F

Fever, swollen left ankle. Redness of left foot.

Large osteomyelitis of left tibia with intramedullary abscesses and significant edema of surrounding muscles (MRI)

Intravenous flucloxacillin and gentamicin

MRSA genotype not clarified

Four weeks of intravenous antibiotics, follow by 4 weeks of oral antibiotic (not clarified)

Recurrent surgical drainage (5 times)

Sever restriction of the motion the left ankle

Haider, 2013, United Kingdom [3]

1

12-years, M

Sore throat, fever, haemoptysis, progressive respiratory failure

Extensive bilateral alveolar pulmonary shadowing (chest X-ray)

Intravenous cefuroxime

Not clarified if MSSA or MRSA

Not clarified

No surgical treatment

Death

Fitzgerald, 2013, United Kingdom [17]

1

14-years, M

Fever, back pain (after rugby training), follow by severe necrotizing pneumonia

Discitis and peridural abscess at L3-L4 (MRI).

Bilateral interstitial infiltrates (chest X-ray)

Intravenous flucloxacillin and clindamycin, followed by ceftriaxone, clindamycin, clarithromycin and linezolid

MSSA genotype not clarified

After 7 days he was treated with intravenous ceftriaxone and oral clindamycin for 3 months

No surgical treatment.

Intravenous immunoglobulin

Complete resolution

Montagnani, 2013, Italy [18]

3

3-months, M

Respiratory distress and poor feeding

Complete atelectasis of left lung, pyopneumothorax and necrotic areas of parenchyma (CT).

Intravenous vancomycin and clindamycin followed by oral linezolid

MRSA ST30

3 weeks

Chest drainage

Complete resolution

 

2-months, M

Subcutaneous abscess in the left perimalleolar area

No bone involvement on ankle MRI

Intravenous teicoplanin and clindamycin

MSSA ST1572

3 weeks

Surgical drainage

Complete resolution

 

2-months, F

Fever, coryza, poor feeding, followed by respiratory distress, drooling, bilateral laterocervical swelling and neck stiffness

Retropharingeal abscess

Intravenous vancomycin and clindamycin, followed by intravenous linezolid and then oral linezolid

MSSA ST576

4 weeks

Surgical drainage

Complete resolution

Karli A, 2015, Turkey [19]

1

13-years, M

Right hip pain, fever

Increase signal in the right iliac crest and increased fluid in the right hip joint. Multiloculated abscess in the gluteal region (MRI).

Necrotizing pneumonia (CT)

Intravenous cefazolin and clindamycin followed by intravenous linezolid and clindamycin and then oral amoxicillin-clavulanate.

MSSA

genotype not clarified.

38 days

Surgical drainage

Complete resolution

Karli A, 2016, Turkey [20]

1

12-years, M

Fever, respiratory distress and hip pain. Poor general condition, somnolence.

Multiple peripherally localized cavitary round lesions in both lungs (CT).

Left psoas muscle abscess and left femoral trochanter osteomyelitis (MRI)

Intravenous vancomycin followed by intravenous linezolid and then oral clindamycin

MSSA genotype not clarified.

21 days of intravenous antibiotic treatment. Not clirifed the duration of oral antibiotic treatment.

Surgical drainage

Complete resolution

Hardgrib, 2016, Denmark [5]

1

13-years, M

Fever, left-side knee pain. Follow by sepsis and respiratory distress

Synovitis with knee joint effusion and signs of medullary osteomyelitis in the proximal tibia (MRI).

Intravenous vancomycin and oral linezolid

MRSA ST30

7 weeks

Multiple surgical drainage

Complete resolution

Ravishankar, 2016, USA [21]

1

10-years, F

Emesis that progressed to respiratory distress, pallor and perioral cyanosis, and near syncope upon standing

Not performed

Intravenous vancomycin and ceftriaxone

MRSA

genotype not clarified

Not applicable

None

Death

Irenji, 2018, United Kingdom [22]

1

13-years, M

Severe right-side groin pain irradiated to his right leg and lower abdomen. Poor general condition, vomiting

Iliac muscle abscess (ultrasound)

Abscesses anterior and posterior to the iliac crest (MRI)

Bilateral consolidation within the lung fields (CT)

Intravenous flucloxacillin and cefotaxime followed by intravenous linezolid and clindamycin.

MSSA

genotype not clarified.

Not clarified

Multiple surgical intervention

Complete resolution

Ogata, 2019, Japan [23]

1

12-years, F

Fever, lower back pain, followed by bladder dysfunction

Panniculitis of the left retroperitoneal region, swelling of the left ileopsoas, and multiple vein thrombosis of the inferior vena cava (CT).

Hyperintensity around the left ileopsoas (MRI).

L4 osteomyelitis and abscess near L3 (MRI)

Intravenous ampicillin and cefotaxime. Followed by intravenous vancomycin subsequently associated with cefazolin and clindamycin. Clindamycin was then substituted with rifampicin.

MSSA

ST2149

Cefazolin for 5 weeks.

Surgical intervention for the abscess near L3

Complete resolution