**5. Panton-Valentine leukocidin**

The identification of Panton-Valentine leukocidin (PVL) genes in the isolates of *Staphylococcus* aureus in children with DVT has been reported in several studies.3,6,8,10,11 These reports suggest that PVL may be associated with enhanced inflammatory response in cases of musculoskeletal infection including pneumonia, multifocal osteomyelitis, bacteremia, and concurrent pyomyositis, subperiosteal abscesses or intra-osseous abscesses requiring surgical debridment.3,6,8,10,11 The advent of rapid PCR technology as a tool to identify the presence of PVL may prove valuable in identifying potentially "silent" cases of DVT that would otherwise go unrecognized. To this point, however, the technology to perform rapid testing to identify the bacterial genetics of the *S*. *aureus* isolates is not readily available at most institutions. Our meta-analysis identified 20 children out of the 58 reported cases with DVT who were found to be PVL positive (34.5%).3,6,8,10,11
