Bacterial peritonitis caused by Kingella kingae.

Area of Science:

• Microbiology
• Infectious Diseases
• Clinical Case Reports

Background:

• Kingella kingae is a Gram-negative coccobacillus, typically a commensal of the human upper respiratory tract.
• While generally benign, K. kingae is an emerging pathogen causing invasive infections, particularly skeletal infections in children and endocarditis in various age groups.
• Patients with underlying conditions such as liver disease may be at increased risk for invasive bacterial infections.

Observation:

• A 55-year-old male patient with a history of liver disease and tense ascites.
• The patient self-administered a paracentesis procedure to manage ascites.
• Following the procedure, the patient developed symptoms indicative of peritonitis and bacteremia.

Findings:

• The paracentesis fluid and blood cultures were positive for Kingella kingae.
• This indicates a direct inoculation of K. kingae into the peritoneal cavity and subsequent bloodstream invasion.
• The case demonstrates a novel route of K. kingae infection secondary to an invasive procedure.

Implications:

• This case expands the known spectrum of invasive Kingella kingae infections.
• It underscores the potential risks associated with non-sterile or self-administered invasive procedures, even with commensal organisms.
• Highlights the importance of considering K. kingae in the differential diagnosis of peritonitis and bacteremia in patients with risk factors, including recent invasive procedures.