Contribution of a Broad Range Polymerase Chain Reaction to the Diagnosis of Osteoarticular Infections Caused by Kingella kingae

Verdier, Isabelle; Gayet-Ageron, Angèle; Ploton, C.; Taylor, Patricia A.; Bénito, Yvonne; Freydière, Anne-Marie; Chotel, Franck; Bérard, J; Vanhems, Philippe; Vandenesch, François

doi:10.1097/01.inf.0000172153.10569.dc

Cited by 130 publications

(87 citation statements)

References 35 publications

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“…Moreover, systematic use of molecular methods on culture-negative samples has been demonstrated to increase the detection of K. kingae in OAI [1,7]. In this study, aerobic blood culture bottles allowed Fig.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, aerobic blood culture bottles allowed Fig. 2 MRI imaging of the same patient, showing subcutaneous tumefaction, arthritis at the junction of the manubrium and xyphoid process with lytic lesions of the lower manubrium and xyphoid process for detection of K. kingae as the responsible pathogen in three cases, and molecular methods (universal 16S rDNA PCR [7], as well as K. kingae-specific real-time PCR [1]) for the detection of K. kingae in the three other cases. Our awareness toward this type of infection in this narrow age group has led to the establishment of the described progressive diagnostic protocol, which we believe to be crucial for detection of K. kingae.…”

Section: Discussionmentioning

confidence: 99%

“…Three of them yielded positive culture for K. kingae in aerobic blood culture bottles. Universal 16S rDNA polymerase chain reaction (PCR) as described elsewhere [7] was obtained in all three cases in which culture was negative. Significant sequence homology (99-100%) with the rDNA sequence of K. kingae was found in two cases.…”

Section: Microbiologic and Molecular Methodsmentioning

confidence: 99%

“…Meanwhile, numerous skeletal manifestations of invasive K. kingae infection have been reported in the literature, owing to increased awareness, improved detection of the organism, or to actual rise in prevalence [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Kingella kingae: osteoarticular infections of the sternum in children: a report of six cases

Luegmair

Chaker

Ploton

et al. 2008

Journal of Children's Orthopaedics

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Purpose 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. Methods 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. Results 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. Conclusion 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Microbiologic and Molecular Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Kingella kingae: osteoarticular infections of the sternum in children: a report of six cases

Luegmair

Chaker

Ploton

et al. 2008

Journal of Children's Orthopaedics

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“…Subacute haematogenous osteomyelitis is most likely due to an atypical host-pathogen relationship that may comprise any combination of: increased host resistance; decreased virulence of the causative organism; and/or prior antibiotic exposure [13,14,20,27,28]. Since the 1980s, the number of K. kingae osteoarticular infections (OAI) has markedly increased [22,23,[29][30][31][32][33] and several current studies indicate that K. kingae is becoming a leading cause of bacterial osteoarticular infections in children aged from 6-48 months [23,30,31]. K. kingae has a naturally low virulence and OAIs caused by this pathogen are characterized by a mild-to-moderate clinical and biological inflammatory response [22,23,29,30,33,34].…”

Section: Discussionmentioning

confidence: 99%

Patellar Subacute Hematogenous Osteomyelitis in Children Due To K. Kingae: A Report of Two Cases

Samara¹,

Steiger²,

Valaikaitė³

et al. 2017

J Infect Dis Preve

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Isolated osteomyelitis of the patella is a rare condition mainly occurring in the pediatric population. Diagnosis is often delayed as clinical presentation manifests with vague anterior knee pain, sometimes with mild local signs of inflammation but frequently without any local signs at all. While falls on the knee can explain mild knee pain, erythema, swelling and persistent peripatellar pain should raise a high index of suspicion for local infection. We present two cases of subacute osteomyelitis of the patella in young children. In both cases bone lesions presented as an osteolytic lesion of the patella. After open biopsy of the lesion, bacteriological analysis confirmed infection with Kingella kingae.Keywords: Osteomyelitis; Kingella kingae; Trauma; Bone edema; Intravenous antibiotics; Radiographic; PCR Level of EvidenceCase reports, level IV. Case Report 1A 14-month-old Caucasian girl was admitted to the emergency department (ED) of our hospital due to persistent limping for more than 2 weeks. There was no history of trauma. A febrile episode (38.7°C) had occurred approximately 2 weeks before presentation at the ED, but as symptoms had decreased progressively no investigations into the cause of infection and no treatment had been undertaken. On admittance to our hospital, the child was afebrile and walked with a stiff knee. Clinical examination revealed right-sided knee pain, slight prepatellar edema, and a mild knee joint effusion. Laboratory results showed a white blood cell count of 17,000 cells/mm 3 , normal Creactive protein (2 mg/dL) and erythrocyte sedimentation rate (11 mm/h), but a high platelet count (520.000cells/mm 3 ). Conventional radiograph showed no significant abnormality. MRI demonstrated prepatellar soft tissue swelling, joint effusion, synovial enhancement and bone edema, all signs compatible with septic arthritis (Figure 1). Moreover, MRI revealed an osteolytic lesion located in the upper part of the right patella with anterior erosion of the cortical bone. The child underwent joint aspiration where a small quantity of mildly opaque liquid was extracted; the joint cavity was then thoroughly irrigated and the patient was immediately started on intravenous antibiotics (cefuroxime). A switch to oral antibiotics was undertaken after 3 days and treatment was continued for another 20 days. No pathogen was cultivated from the joint fluid, but K. kingae specific rtPCR gave a positive result. At the final clinical control, 12 months after surgery, the child did not complain about any pain and gait was normal. The clinical exam did not reveal any tenderness, swelling or erythema around the knee and the range of motion of the right knee joint was normal. Radiographs showed a normal patella without pathological findings.

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Pathogenesis of Kingella kingae Infections

Yagupsky¹

2015

Human Emerging and Re‐emerging Infections

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Contribution of a Broad Range Polymerase Chain Reaction to the Diagnosis of Osteoarticular Infections Caused by Kingella kingae

Abstract: Use of molecular diagnostic methods increases the identification of K. kingae in osteoarticular infections.

Cited by 130 publications

References 35 publications

Kingella kingae: osteoarticular infections of the sternum in children: a report of six cases

Kingella kingae: osteoarticular infections of the sternum in children: a report of six cases

Patellar Subacute Hematogenous Osteomyelitis in Children Due To K. Kingae: A Report of Two Cases

Pathogenesis of Kingella kingae Infections

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