<i>kingella kingae</i> infectious arthritis: case report and review of literature of kingella and moraxella infections

Patel, Nirupa J.; Moore, Terry L.; Weiss, Terry D.; Zuckner, Jack

doi:10.1002/art.1780260417

Cited by 25 publications

(4 citation statements)

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“…Kingella kingae osteomyelitis has been described as a relatively indolent infection with a subacute course, often leading to lengthy delays prior to diagnosis. 2,3,11,15,21–26 In support of this, the average time to diagnosis was 16 days, and fevers above 38°C were documented in only 35%. The mean WCC and ESR were 12.3 × 10 9 /L and 43 mm/h, respectively.…”

Section: Discussionmentioning

confidence: 82%

“…The mean WCC and ESR were 11.1 × 10 9 /L and 48 mm/h, respectively. The disease was monoarthritic in all cases; the affected joint being the knee in 17, 11,14,16,23,25,35 the hip in eight, 6,11,15,28–35 the ankle in nine, 14–16,28 the wrist in two, 14,36 the shoulder in two, 14 the elbow in two, 15,16 and the sternoclavicular joint and the talocalcaneal joint in one each. 26,28 All except two cases 22,37 were diagnosed by positive synovial fluid culture, the Gram stain of which showed Gram‐negative rods in only four cases.…”

Section: Discussionmentioning

confidence: 93%

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Kingella kingae infections in children

Dodman

Robson

Pincus

2000

J Paediatrics Child Health

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 93%

Kingella kingae infections in children

Dodman

Robson

Pincus

2000

J Paediatrics Child Health

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“…The disease generally involves the large weight-bearing knee, ankle, or hip joints in over 80% of cases (15,102,(157)(158)(159)(160), followed by the wrist, shoulder, and elbow (102,(160)(161)(162)(163)(164)(165)(166)(167)(168)(169). However, the metacarpophalangeal, sternoclavicular, tarsal, and sacro-iliac joints (148,(170)(171)(172)(173), which are rarely affected by other bacterial species, are involved with unusual frequency in K. kingae arthritis (18).…”

Section: Skeletal System Infectionsmentioning

confidence: 99%

Kingella kingae: Carriage, Transmission, and Disease

2015

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SUMMARY Kingella kingae is a common etiology of pediatric bacteremia and the leading agent of osteomyelitis and septic arthritis in children aged 6 to 36 months. This Gram-negative bacterium is carried asymptomatically in the oropharynx and disseminates by close interpersonal contact. The colonized epithelium is the source of bloodstream invasion and dissemination to distant sites, and certain clones show significant association with bacteremia, osteoarthritis, or endocarditis. Kingella kingae produces an RTX (repeat-in-toxin) toxin with broad-spectrum cytotoxicity that probably facilitates mucosal colonization and persistence of the organism in the bloodstream and deep body tissues. With the exception of patients with endocardial involvement, children with K. kingae diseases often show only mild symptoms and signs, necessitating clinical acumen. The isolation of K. kingae on routine solid media is suboptimal, and detection of the bacterium is significantly improved by inoculating exudates into blood culture bottles and the use of PCR-based assays. The organism is generally susceptible to antibiotics that are administered to young patients with joint and bone infections. β-Lactamase production is clonal, and the local prevalence of β-lactamase-producing strains is variable. If adequately and promptly treated, invasive K. kingae infections with no endocardial involvement usually run a benign clinical course.

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“…Later it was named Moraxella kingii (15), corrected to Moraxella kingae (3), and finally allocated to the genus Kingella as K. kingae within the family Neisseriaceae (16). Although the organism is considered to be of low pathogenicity (16,22,23), it has been shown to be a significant pathogen in human diseases, particularly in children (2,5,8,22,28), with an apparent tropism for valvular and skeletal tissue (5,6,8). Here, we report two additional cases of K. kingae infection in children: a spondylitis and an osteomyelitis.…”

mentioning

confidence: 99%