Idiopathic neonatal necrotising fasciitis caused by community-acquired MSSA encoding Panton Valentine Leukocidin genes.
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Affiliation
Department of Plastic and Reconstructive Surgery, Our Lady's Children's Hospital,, Crumlin, Dublin 12, Ireland. rledunlop@gmail.comIssue Date
2012-02-01T10:24:07ZMeSH
Bacterial Toxins/geneticsBacterial Typing Techniques
Buttocks
Combined Modality Therapy
Community-Acquired Infections/*microbiology/therapy
Exotoxins/genetics
Fasciitis, Necrotizing/*microbiology/therapy
Gene Transfer, Horizontal/genetics
Humans
Infant, Newborn
Leukocidins/genetics
Male
Methicillin Resistance/genetics
Microbial Sensitivity Tests
Staphylococcal Infections/*microbiology/therapy
Staphylococcus aureus/genetics
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J Plast Reconstr Aesthet Surg. 2011 Nov;64(11):1522-4. Epub 2011 Apr 20.Journal
Journal of plastic, reconstructive & aesthetic surgery : JPRASDOI
10.1016/j.bjps.2011.03.041PubMed ID
21511548Abstract
Neonatal necrotising fasciitis is very rare in comparison to the adult presentation of the disease and a Plastic Surgeon may only encounter one such case during his or her career. Often this is initially misdiagnosed and managed as simple cellulitis. It generally affects previously healthy babies, the site is often the lower back area and a history of minor skin trauma may be elicited. The causative organism is usually Streptococcus or polymicrobial, as is the case in the adult population. We present the case of a previously healthy 11-day-old infant with idiopathic, rapidly progressive necrotising fasciitis of the back, cause by Methicillin sensitive Staphylococcus aureus (MSSA) infection. The strain was isolated and found to encode the Panton-Valentine Leukocidin genes, which have been associated with particularly severe necrotising infections in other sites, with high mortality. These strains are the subject of specific treatment and eradication guidance in the UK but awareness of this and the importance of obtaining detailed culture typing is likely to be low amongst Plastic Surgeons.Language
engISSN
1878-0539 (Electronic)1748-6815 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.bjps.2011.03.041
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