AUTHOR=Goemanne Sophie , Tilmanne Anne , Biarent Dominique , Smeesters Pierre , Simoni Paolo , Mahadeb Bhavna Ansuya , Vicinanza Alfredo 

TITLE=Severe Staphylococcus aureus infections in children: Case reports and management of positive Panton-Valentine leucocidin cases

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.1003708

DOI=10.3389/fped.2022.1003708

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p><italic>Staphylococcus aureus</italic> is a well-known bacterium associated with carriage and responsible for different types of infections. The Panton-Valentine leucocidin (<italic>PVL</italic>) is a key virulence factor causing tissue necrosis. <italic>PVL</italic> can, however, be present in both benign and life-threatening infections.</p></sec><sec><title>Case reports and management</title><p>We present three pediatric severe infections occurring over a period of only three weeks, in February 2021, and caused by genetically unrelated methicillin-sensitive <italic>Staphylococcus aureus</italic> producing <italic>PVL</italic> in a tertiary children’s hospital in Belgium. The first one presented with necrotizing pneumonia, the second one with a neck abscess extended to the mediastinum, and the last one had sacral osteomyelitis complicated by endocarditis. The management of these infections is mostly based on expert opinions. The most appropriate treatment seems to be the combination of early surgical drainage of infected collections with an antibiotic regimen associating two antibiotics; beta-lactams and either clindamycin or linezolid. Human immunoglobulins also appear to be useful as adjunctive therapy.</p></sec><sec><title>Conclusion</title><p><italic>PVL</italic>-producing <italic>Staphylococcus aureus</italic> is associated with life-threatening infections in children. Prompt management is needed including surgery and appropriate antibiotic regimens.</p></sec>