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Serious life-threatening multifocal infection in a child, caused by Panton-Valentine leucocidin-producing Staphylococcus aureus (PVL-MSSA)
  1. Neda Irenji1,
  2. Suresh Kumar Gopala Pillai2,
  3. Jennifer Susan West-Jones3
  1. 1 Department of Medicine, Abertawe Bro Morgannwg University Health Board, Swansea, UK
  2. 2 Intensive Care Department, Morriston Hospital, Swansea, UK
  3. 3 Emergency Department, Abertawe Bro Morgannwg University Health Board, Swansea, UK
  1. Correspondence to Dr Neda Irenji, nedairenji{at}


Groin pain is a frequently occurring complaint in presentations to the Emergency Department. Muscular sprain is often a differential diagnosis, however serious conditions such as pyomyositis should not be ignored. This case report presents a child with atraumatic right groin pain, which was initially diagnosed as a muscular sprain. The patient later re-presented out of hours to the Emergency Department with what was found to be extensive pelvic abscesses. He was subsequently found to have bilateral pneumonia and later developed a pericardial effusion and osteomyelitis of the right iliac bone, sacroiliac joint and sacrum. With multiple surgical interventions and appropriate antibiotics, he made a full recovery and was discharged home after a total admission time of 41 days. The causative organism was found to be Panton-Valentine leucocidin-positive methicillin-susceptible Staphylococcus aureus.

  • orthopaedic and trauma surgery
  • infections
  • emergency medicine
  • bone and joint infections
  • paediatrics (drugs and medicines)
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  • Contributors NI, SKGP and JSW-J saw this case in the emergency department. NI wrote the case report and obtained consent from the patient and guardian. SKGP and NI performed the literature search. SKGP and JSW-J critically appraised the article and contributed to make necessary changes in the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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