Panton-Valentine leukocidin toxin has been known about for many years and its production by Staphylococcus aureus in infections is associated with invasive necrotising disease of several systems including skin and soft tissue, and pneumonia. Necrotising pneumonia is associated with high mortality despite provision of antimicrobials and affects predominately younger aged people. A combination of antimicrobial therapy including an agent which acts to inhibit bacterial protein synthesis (such as clindamycin, linezolid, or rifampicin) is the mainstay of therapy with intravenous immunoglobulin, a potentially useful adjunct. Contact screening and public health input is essential in preventing further cases and recolonisation. When PVL toxin producing staphylococcal infection is suspected, close liaison with medical microbiology is paramount to enable optimal treatment and suitable specimens to be sent to the reference laboratory for confirmation.