Article

Kingella kingae: Osteoarticular infections of the sternum in children: A report of six cases

Department of Orthopaedic Surgery, University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria, .
Journal of Children s Orthopaedics 01/2009; 2(6):443-7. DOI: 10.1007/s11832-008-0144-7
Source: PubMed

ABSTRACT

Kingella kingae is increasingly recognized as a pathogen of osteoarticular infections (OAI) below the age of 2 years. It was reported that bones and joints which are rarely infected by other pathogens were frequently invaded by K. kingae. Based on a series of six cases, we present the typical clinical and paraclinical manifestation of K. kingae infections of the sternum and sterno-manubrial joint.
A review of the clinical, laboratory, radiological, microbiological, and molecular data of six consecutive children admitted to a paediatric unit for OAI of the sternum was done.
Culture alone allowed for the detection of K. kingae as the responsible pathogen in three cases, molecular methods in the three other cases. Clinical and laboratory findings, as well as imaging methods, proved to be useful in the diagnostic process.
Our findings suggest that infections of the lower sternum and the junction between the manubrium and the xyphoid process are typical, if not pathognomonic, for the organism. A respective diagnostic and therapeutic protocol was established.

  • [Show abstract] [Hide abstract]
    ABSTRACT: As a result of the use of blood culture vials for seeding joint and bone exudates, and the development of nucleic acid amplification methods, Kingella kingae is being increasingly recognized as an emerging invasive pathogen and the most common etiology of septic arthritis in children aged 6-36 months. K. kingae is carried asymptomatically in the pharynx, and is transmitted from child-to-child by close contact between family members and playmates. K. kingae organisms enter the bloodstream through breaches in the respiratory mucosa and disseminate to remote sites. Skeletal system infections are the most common presentations of K. kingae disease, followed by bacteremia, pneumonia and endocarditis. Children with invasive K. kingae infections frequently show a mild clinical picture and normal acute-phase reactants, requiring a high index of suspicion. The organism is usually susceptible to antibiotics and, with the exception of endocarditis cases, most patients promptly respond to adequate antimicrobial therapy with no permanent sequelae.
    No preview · Article · Jun 2010 · Pediatric Health
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Klebsiella oxytoca is known to be a pathogen in immunodeficient adults and children. Here we report the first case of a K. oxytoca infection associated with spontaneous arthritis of the knee in a child with no history of immunosuppressive therapy or previous bacterial infections. Despite an initial antibiotic treatment failure, a second treatment led to a cure of the infection with no joint sequelae.
    Full-text · Article · Aug 2010 · Journal of clinical microbiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: For most of the four decades that have elapsed since the first description of Kingella kingae, this Gram-negative ß-hemolytic member of the Neisseriaceae family was considered exceptional rare cause of human disease, infrequently isolated from infected joints, bones and cardiac valves [1-3]. The serendipitous discovery that inoculation of synovial fluid and bone exudates into blood culture vials (BCV) significantly improved detection of the organism, resulted in the appreciation of K. kingae as an emerging invasive pathogen in young children [4-7]. Since the last time this topic was covered in this series [8], increasing adoption of the BCV technique for culturing joint and bone aspirates and growing familiarity of clinical microbiology laboratories with the identification of the organism, coupled with the development of nucleic acid amplification techniques (NAAT) [9-11], has considerably increased our knowledge of K. kingae. The present review summarizes recent advances in the detection, epidemiology, clinical presentation, pathogenesis, immunology, and treatment of pediatric infections caused by the organism.
    No preview · Article · Jan 2011 · Advances in Experimental Medicine and Biology
Show more