Author/Editor		Battelino, Nina; Pokorn, Marko; Švent-Kučina, Nataša; Križan-Hergouth, Veronika; Novljan, Gregor
Title		Fulminant peritonitis presumably caused by panton-valentine leukocidin-positive staphylococcus aureus in a girl on peritoneal dialysis
Type		članek
Source		In: Special issue : contributions from the 5th Slovenian Congress of Nephrology with international participation [S. l.] : International Society for Apheresis
Publication year		2013
Volume		str. 431-437
Language		eng
Abstract		Peritonitis is a significant complication of peritoneal dialysis (PD) and the most common cause of technique failure. Panton-Valentine leukocidin (PVL), a cytotoxin produced by certain strains of Staphylococcus aureus (SA), causes destruction of neutrophils, and is associated with severe invasive infections.We present a 2.5-year-old girl on PD, who presented suddenly with an unusually fulminant and protracted course of peritonitis. Only a few hours after the onset of clinical signs, septic shock developed. PVLpositive methicillin-sensitive SA (MSSA) was grown and initial empiric antibiotic treatment changed to flucloxacillin and rifampicin in order to minimize toxin production. In spite of adequate antibiotic treatment and PD-catheter removal, recovery was slow. No PD-related peritonitis in children associated with PVL-producing strains have been reported so far and no specific recommendation exists for treatment.We speculate that PVL contributed to the severity and outcome of peritonitis in our patient. KeyWords: Children, Panton-Valentine leukocidin, Peritoneal dialysis, Peritonitis, Staphylococcus aureus.
Keywords		peritonitis peritoneal dialysis staphylococcus aureus