Community-Acquired Necrotizing Pneumonia due to Panton-Valentine Leukocidin-Producing Methicillin-Sensitive Staphylococcus aureus

The Panton Valentine Leukocidin (PVL), produced by Staphylococcus aureus (SA) strains, is a potent virulence factor associated with severe invasive disease. One of the most serious clinical presentations, necrotizing pneumonia, frequently presents in previously healthy young individuals. However, PVL presence is not routinely tested, and strong clinical suspicion should guide clinicians, since appropriate antimicrobial therapy, with the association of agents capable of PVL production inhibition, is crucial. The authors hereby present a case report of a young, previously healthy adult male, admitted to an Intensive Care Unit due to acute hypoxemic respiratory failure. The patient evolved with a severe necrotizing pneumonia due to methicillin-susceptible Staphylococcus aureus (MSSA) and Klebsiella pneumoniae requiring two beta-lactam antibiotic therapy and invasive mechanical ventilation. Persistent clinical deterioration led to the clinical suspicion of an underlying PVL-producing SA strain. The patient evolved favourably with the association of linezolid and laboratory testing posteriorly confirmed PVL-producing MSSA.