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
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.

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    • "CT-scan has a greater sensitivity in precising the extension of the infection, especially retrosternal or mediastinal abscess and bone irregularities, but is performed under general anaesthesia in infants and should be considered only if ultrasound evaluation does not provide sufficient information for accurate diagnosis [5, 6]. The most common microorganism found in osteoarticular infections is Staphylococcus aureus, while Streptococcus pneumoniae and Kingella kingae are also found in infants especially between the ages of 2 months and 5 years [3, 7, 8]. Therefore, antibiotics against Staphylococcus aureus should be the empiric treatment of first choice [9]. "
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