Pierre Louis Conan1, Isabelle Podglajen2, Fabrice Compain2, Mehdi Osman3, David Lebeaux1, Edouard Flamarion3. 1. Unité Mobile de Microbiologie Clinique, Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. 2. Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. 3. Département de médecine interne, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
Abstract
BACKGROUND: Renal abscesses are rare and mainly caused by an ascending infection due to Gram-negative microorganisms. We report the first case of a renal abscess caused by Panton-Valentine leukocidin-producing Staphylococcus aureus in an immunocompetent patient, and we present a comprehensive review of the literature. CASE PRESENTATION: A 20-year-old immunocompetent woman had a 2-month history of left-sided back pain, fever and urinary symptoms. Urinalysis showed leukocyturia (19,000/mm3) without bacteriuria. Intravenous cefotaxime treatment was initiated. A computed tomographic scan showed a large abscess in the left kidney. Computed tomographic percutaneous drainage was done and cultures of abscess and blood grew methicillin-susceptible Panton-Valentine leukocidin-producing Staphylococcus aureus. Treatment was switched to cefazoline and then to clindamycin for 21 days. The patient quickly improved and the abscess was completely resolved 6 months after end of antibiotic treatment. CONCLUSION: To our knowledge, this is the first report of a renal abscess caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. Treatment with percutaneous drainage and an antibiotic with toxin inhibiting effect was successful.
BACKGROUND: Renal abscesses are rare and mainly caused by an ascending infection due to Gram-negative microorganisms. We report the first case of a renal abscess caused by Panton-Valentine leukocidin-producing Staphylococcus aureus in an immunocompetent patient, and we present a comprehensive review of the literature. CASE PRESENTATION:A 20-year-old immunocompetent woman had a 2-month history of left-sided back pain, fever and urinary symptoms. Urinalysis showed leukocyturia (19,000/mm3) without bacteriuria. Intravenous cefotaxime treatment was initiated. A computed tomographic scan showed a large abscess in the left kidney. Computed tomographic percutaneous drainage was done and cultures of abscess and blood grew methicillin-susceptible Panton-Valentine leukocidin-producing Staphylococcus aureus. Treatment was switched to cefazoline and then to clindamycin for 21 days. The patient quickly improved and the abscess was completely resolved 6 months after end of antibiotic treatment. CONCLUSION: To our knowledge, this is the first report of a renal abscess caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. Treatment with percutaneous drainage and an antibiotic with toxin inhibiting effect was successful.