Panton-Valentine leucocidin (PVL) is a cytotoxin produced by Staphylococcus aureus that lyses leucocytes by creating pores on the cell surface. PVL was first detected in meticillin susceptible S aureus (MSSA) and then later in meticillin resistant S aureus (MRSA). Awareness of diseases related to PVL has increased since the worldwide emergence of these community acquired MRSA strains. In the United States, PVL positive MRSA has been associated with outbreaks of skin and soft tissue infection and sporadic life threatening diseases.1 2 In contrast, in Europe, especially in the United Kingdom, PVL positive S aureus strains are more commonly meticillin susceptible.3 4 Therefore, in the US, Switzerland, and Canada national guidelines for managing PVL positive S aureus disease are recommended for MRSA infections and in the UK for both MRSA and MSSA infections.

Regardless of meticillin resistance, PVL positive S aureus cause either recurrent spontaneous skin infections or rare severe illnesses, such …