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Clinical Features and Comparison of Kingella and Non-Kingella Endocarditis in Children, Israel

Alexander Lowenthal, Hila Weisblum-Neuman, Einat Birk

    Emerging Infectious Diseases
    |February 24, 2021
    PubMed

    Insights

    Kingella infective endocarditis (KIE) is increasingly seen in children. This study found KIE presents uniquely in young boys with oral aphthae, differing from Streptococcus and Staphylococcus infections.

    Area of Science:

    • Pediatric Infectious Diseases
    • Cardiology
    • Microbiology

    Background:

    • Kingella species (spp.) are increasingly recognized as significant pathogens in invasive pediatric infections.
    • Data regarding Kingella infective endocarditis (KIE) in pediatric populations remain limited.
    • Infective endocarditis (IE) in children necessitates understanding causative agents and clinical presentations.

    Purpose of the Study:

    • To compare the clinical features of pediatric Kingella infective endocarditis (KIE) with those of Streptococcus species IE (StIE) and Staphylococcus aureus IE (SaIE).
    • To identify unique characteristics of KIE in children to aid in early diagnosis and treatment.
    • To highlight the rising incidence of KIE in pediatric cases.

    Main Methods:

    • Retrospective analysis of 60 pediatric patients diagnosed with infective endocarditis.
    • Comparison of clinical data between KIE, StIE, and SaIE patient groups.
    • Statistical analysis to determine significant differences in patient demographics and clinical findings.

    Main Results:

    • A notable increase in the incidence of KIE was observed during the study period.
    • KIE patients were significantly younger than StIE and SaIE patients.
    • KIE was more prevalent in boys and associated with higher admission temperatures, prior oral aphthae, and elevated lymphocyte counts.

    Conclusions:

    • Pediatric KIE presents with distinct clinical features compared to IE caused by Streptococcus and Staphylococcus species.
    • Kingella should be suspected in young children (<36 months), particularly boys, with signs of endocarditis, especially if they have a history of oral aphthae and/or congenital heart defects.
    • Early recognition of KIE's unique presentation is crucial for prompt diagnosis and management in pediatric patients.

    Keywords:
    IsraelKingella speciesStaphylococcus aureusStreptococciStreptococcus speciesbacteremiabacteriabacterial infectioninfective endocarditisoral aphthaepediatric

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