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BMJ 2005;331:793-794 (8 October), doi:10.1136/bmj.331.7520.793
A rare but often lethal cocktail that can complicate flu
| The first 150 words of the full text of this article appear below. |
Panton-Valentine leukocidin (PVL) is one of many toxins produced by Staphylococcus aureus. Structurally similar to
haemolysin, this leukocidin comprises two subunits (F and S) that together are leukocidal and dermonecrotic.1 Intermixing of
haemolysin and the subunits of PVL produces toxin molecules with varying cellular affinities and destructive capability, even when the staphylococci may be otherwise sensitive to antibiotics such as methicillin. The death of a fit young soldier in the United Kingdom earlier this year from toxicity to PVL illustrated the extent of that capability.2
Infection with PVL producing staphylococci is rare. Fewer than 2% of clinical isolates of S aureus examined in the United Kingdom in 2002-3 had the genes to produce the leukocidin, although it was found in 4.6% of samples from infections of skin and soft tissue.3 Furthermore, "pure" disease caused by those S aureus bacteria that produce PVL is rarely life threatening. It presents as
Marina Morgan, consultant medical microbiologist
Royal Devon and Exeter Foundation Trust, Exeter EX2 5AD (marina.morgan@rdehc-tr.swest.nhs.uk)
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