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Unusually severe cases of Kingella kingae osteoarticular infections in children

Cindy Mallet1, Dimitri Ceroni, Estelle Litzelmann

  • 1From the *Pediatric Orthopedic Department, Robert Debré University Hospital, Paris, France; †Pediatric Orthopedic Department, University Hospital of Geneva, Geneva, Switzerland; ‡Pediatric Department; and §Microbiology Department, Robert Debré University Hospital, Paris, France.

The Pediatric Infectious Disease Journal
|July 17, 2013
PubMed

Insights

Severe osteoarticular infections in children caused by Kingella kingae can present atypically. Early detection and treatment are crucial to prevent potential long-term bone damage.

Area of Science:

  • Pediatric Infectious Diseases
  • Molecular Microbiology
  • Skeletal Infections

Background:

  • Kingella kingae is a common cause of osteoarticular infections in young children.
  • Typical K. kingae infections present with mild symptoms and favorable outcomes.
  • This study investigates unusually severe cases of K. kingae osteoarticular infections.

Purpose of the Study:

  • To describe the clinical characteristics and outcomes of severe pediatric osteoarticular infections caused by K. kingae.
  • To highlight diagnostic challenges and potential complications associated with these severe cases.

Main Methods:

  • Retrospective review of severe osteoarticular infections in two European pediatric centers.
  • Identification of K. kingae using real-time polymerase chain reaction (PCR) in clinical samples.
  • Analysis of clinical, laboratory, and radiographic data during hospitalization and follow-up.

Main Results:

  • Ten children with severe K. kingae osteoarticular infections were identified (mean age 21 months).
  • Diagnostic delay averaged 13.2 days; 50% had normal C-reactive protein levels at presentation.
  • All patients received surgical treatment and antibiotics; all had satisfactory outcomes, with two developing epiphysiodesis without significant consequence.

Conclusions:

  • Delayed diagnosis of K. kingae osteoarticular infections can occur due to mild initial symptoms.
  • Prompt detection and treatment are essential to prevent bony lytic lesions and growth cartilage damage.
  • Despite severe presentation, K. kingae infections can lead to favorable outcomes with appropriate management.
Abstract

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