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Orbital cellulitis from Panton-Valentine leucocidin-positive methicillin-resistant Staphylococcus aureus Yusuke Tatara 1,3 , Masahiro Kogiso 1 , Yuka Sogabe 2 , Yuki Nakano 3 , Kiyoshi Suzuma 3 1Department of Ophthalmology, Shikoku Medical Center for Children and Adults 2Department of Ophthalmology, Mitoyo General Hospital 3Department of Opthalmology, Kagawa University Faculty of Medicine pp.1067-1072
Published Date 2023/8/15
DOI https://doi.org/10.11477/mf.1410214887
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Abstract Purpose:Orbital cellulitis is an acute pyogenic inflammation that occasionally causes severe visual dysfunction. We report a case of orbital cellulitis caused by methicillin-resistant Staphylococcus aureus(MRSA), which produces Panton-Valentine leukocidin(PVL), a toxin specific to leukocytes.

Subject:A 61-year-old woman was referred to our hospital due to orbital cellulitis.

Observation:At initial examination, we observed severe swelling and rubefaction of the right upper eyelid, severe hyperemia and edema of the ocular conjunctiva, protrusion of the right eyeball, and ocular motor failure. Blood tests showed elevated white blood cell counts and C-reactive protein levels, and computed tomography findings indicated increased inflammation in the orbital lipid tissue, leading to a diagnosis of orbital cellulitis. We administered an intravenous carbapenem antibiotic drip and anti-MRSA antibiotics. Improvement was noted 10 days after treatment.

Conclusion:PVL is a leukocyte-specific toxin characteristically produced by MRSA and is associated with pathogenesis severity. We managed a case of severe orbital cellulitis caused by PVL-producing MRSA, which took a long time to resolve despite normal immunity. On suspecting the causative organism to be Staphylococcus aureus, we had to consider the possibility of PVL-producing MRSA and ensure appropriate antibiotic selection.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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