Kingella kingae Spinal Infections in Children
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Published on: October 29, 2014
Eleftheria Samara1, Nicolas Lutz1, Pierre-Yves Zambelli1
1Pediatric Orthopedic Department, Children's Hospital, Chémin de Montétan 16, 1004 Lausanne, Switzerland.
Insights
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.
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.
Abstract:
Nowadays, Kingella kingae is considered an important cause of primary spinal infections in children aged between 6 and 48 months. The presentation of the disease is often characterized by mild clinical features and a moderate biological inflammatory response, requiring a high index of suspicion. Performing magnetic resonance imaging (MRI) and obtaining an oropharyngeal specimen and subjecting it to a K. kingae-specific nucleic acid amplification test are recommended for its diagnosis. Most patients respond promptly to conservative treatment after administration of antibiotic therapy, which is prolonged for up to 3 months according to the individual clinical and biological response. Invasive surgical procedures are not required except for children who do not improve with antibiotic treatment, develop signs of cord compression, or if the presence of atypical microorganisms is suspected. Kingella kingae spinal infections usually run an indolent and benign clinical course, living no permanent sequelae.
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