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Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Endocarditis I: Introduction01:25

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Related Experiment Video

Updated: Nov 16, 2025

Knee Arthrocentesis in Adults
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Kingella kingae septic arthritis.

Mohammed Khattak1, Sujith Vellathussery Chakkalakumbil1, Robert A Stevenson1

  • 1Alder Hey Children's Hospital, Liverpool, UK.

The Bone & Joint Journal
|March 1, 2021
PubMed
Summary

Kingella kingae is the most common cause of pediatric septic arthritis, often missed by routine cultures. Early suspicion and PCR testing are crucial for timely diagnosis in young children with atypical presentations.

Keywords:
ESR/CRP ratioKingella kingaePolymerase chain reactionSeptic arthritis

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Area of Science:

  • Pediatric infectious diseases
  • Orthopedic surgery
  • Clinical microbiology

Background:

  • Septic arthritis in children requires prompt diagnosis and treatment.
  • Kingella kingae is an increasingly recognized pathogen in pediatric septic arthritis.
  • Distinguishing K. kingae from other causative organisms is important for appropriate management.

Purpose of the Study:

  • To compare patient demographics, clinical features, and blood parameters in K. kingae septic arthritis versus septic arthritis caused by other organisms.
  • To assess the diagnostic utility of polymerase chain reaction (PCR) for K. kingae detection.
  • To inform clinical suspicion and diagnostic strategies for pediatric septic arthritis.

Main Methods:

  • Prospective case series of children with suspected septic arthritis at a UK pediatric institution (October 2012 - November 2018).
  • Inclusion of clinical, biochemical, and microbiological data, including culture and PCR analysis.
  • Comparison of findings between K. kingae-positive cases and those with other organisms or no identified pathogen.

Main Results:

  • Kingella kingae was the most common organism (42%) in culture- and/or PCR-positive septic arthritis cases.
  • K. kingae infections were predominantly diagnosed by PCR (66%), with routine cultures often negative.
  • K. kingae-positive patients were significantly younger (mean 16.1 months) with lower CRP and higher ESR/CRP ratios compared to other organisms.

Conclusions:

  • Kingella kingae is the leading cause of pediatric septic arthritis, frequently requiring PCR for diagnosis.
  • Clinical suspicion for K. kingae should be maintained in young children with atypical presentations.
  • Routine PCR testing is recommended for suspected pediatric septic arthritis to improve K. kingae detection.