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Kingella kingae Spinal Infections in Children.

Eleftheria Samara1, Nicolas Lutz1, Pierre-Yves Zambelli1

  • 1Pediatric Orthopedic Department, Children's Hospital, Chémin de Montétan 16, 1004 Lausanne, Switzerland.

Children (Basel, Switzerland)
|May 28, 2022
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Summary

Kingella kingae is a common cause of spinal infections in young children, often presenting with subtle symptoms. Early diagnosis via nucleic acid amplification tests and prompt antibiotic treatment typically lead to full recovery without long-term issues.

Keywords:
Kingella kingaePaediatric infectionspinal infections

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Area of Science:

  • Pediatric Infectious Diseases
  • Pediatric Orthopedics
  • Microbiology

Background:

  • Kingella kingae is an increasingly recognized pathogen causing primary spinal infections in young children (6-48 months).
  • These infections often present with mild clinical signs and moderate inflammatory markers, necessitating a high index of suspicion for diagnosis.
  • The typical presentation can mimic less severe conditions, delaying appropriate management.

Purpose of the Study:

  • To highlight the diagnostic and management strategies for Kingella kingae spinal infections in children.
  • To emphasize the importance of early and accurate diagnosis to guide treatment.
  • To describe the usual clinical course and outcomes of these infections.

Main Methods:

  • Diagnosis relies on clinical suspicion, advanced imaging like MRI, and specific molecular testing (nucleic acid amplification tests) on oropharyngeal swabs.
  • Treatment involves prolonged antibiotic therapy (up to 3 months) tailored to clinical and biological response.
  • Invasive procedures are reserved for non-responsive cases, signs of neurological compromise, or suspicion of other pathogens.

Main Results:

  • Kingella kingae spinal infections in children generally exhibit an indolent and benign clinical course.
  • Most children respond well to conservative management with antibiotics, avoiding the need for surgery.
  • Long-term sequelae are uncommon following appropriate treatment.

Conclusions:

  • Kingella kingae is a significant cause of pediatric spinal infections requiring specific diagnostic approaches.
  • Conservative management with prolonged antibiotics is effective for most cases.
  • Prompt diagnosis and treatment lead to favorable outcomes with minimal long-term impact.