Abstract
By the description of two cases of osteoarticular infections due toKingella kingae in two young children we sish to draw the attention of clinicians to invasive infections due to this micro-organism. Since its biological characterization in 1976,K. kingae has been increasingly reported as a human pathogen. Most common presentations are endocarditis, bacteraemia, septic arthritis, osteomyelitis and spondylodiscitis. Interestingly, osteorticular involvement is largely predominant in previously healthy children. From the literature, we reviewed 51 cases ofK. kingae bone and joint infections, representing 23 cases of septic arthritis, 17 of osteomyelitis and 11 spondylodiscitis. Of the cases 88% occurred in children below 5 years of age and in all cases only one bone or joint was involved. An underlying disorder could be found in only 4 patients. Since these infections have a favourable outcome with intravenous antibiotic treatment, proper isolation and identification ofK. kingae is essential.
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References
Alexander CJ (1970) The aetiology of juvenile spondylarthritis (discitis). Clin Radiol 21:178–187
Bosworth DE (1983)Kingella (Moraxella) kingae infections in children. Am J Dis Child 137:650–653
Bovre K, Henriksen SD, Jonsson V (1974) Correction of the specific epithet kingii in the combinations Moraxella kingii Henriksen and Bovre 1968 and Pseudomonas kingii Jonsson 1970 to kingae. Int J Sys Bacteriol 24:307
Boyce F, Cassidy M, Price R (1983)Kingella kingae septic arthritis. Clin Microbiol 5:46
Bye WD, Taylor TKF (1978) Antibiotics in the management of inflammatory lesions of the intervertebral discs in young children. Aust NZ J Surg 48:70–73
Chanal C, Tiget F, Chapuis P, Campagne D, Jan M, Sirot J (1987) Spondylitis and osteomyelitis caused byKingella kingae in children. J. Clin Microbiol 25:2407–2409
Christensen CE, Emmanouilides GC (1967) Bacterial endocarditis due to ‘Moraxella new species 1’. N Engl J Med 277:803–804
Claesson B, Falsen E, Kjellman B (1985)Kingella kingae infections: a review and a presentation of data from 10 swedish cases. Scand J Infect Dis 17:233–243
Clement JL, Berard J, Cahuzac JP, Gaubert J (1988)Kingella kingae osteorathritis and osteomyellitis in children. J Pediatr Orthop 8:59–61
Davis JM, Peel MM (1982) Osteomyelitis and septic arthritis caused byKingella kingae. J Clin Pathol 35:219–222
De Groot R, Glover D, Clausen C, Smith AL, Wilson CB (1988) Bone and joint infections caused byKingella kingae: Six cases and review of the literature. Rev Infect Dis 10:998–1004
Eismont FJ, Bohlman HH, Soni PL, Goldberg VM, Freehafer AA (1982) Vertebral osteomyelitis in children. J Bone Joint Surg [Br] 64-B:32–35
Forstl H, Ruckdeschel G, Lang M, Eder W (1984) Septicemia caused byKingella kingae. Eur J Clin Microbiol 3:267–269
Franklin GW, Shafi NA (1983) Spontaneous septic arthritis due toKingella kingae. Clin Microbiol 5:53–54
Freij BJ, Kusmiesz H, Shelton S, Nelson JD (1987) Imipenem and cilastatin in acute osteomyelitis and suppurative arthritis. Am. J Dis Child 141:335–342
Galil A, Gorodisher R, Bar-Ziv J, Hallel T, Malkin C, Garty R (1982) Intervertebral disc infection (discitis) in childhood. Eur J Pediatr 139:66–70
Gamble JG, Rinsky LA (1988)Kingella kingae infection in healthy children. J Pediatr Orthop 8:445–449
Gay RM, Lane TW, Keller DC (1983) Septic arthritis caused byKingella kingae. J Clin Microbiol 17:168–169
Grant JM, Bortolussi RA, Roy DL, Wort J (1983) Prosthetic valve bacterial endocarditis caused byKingella kingae. Can Med Assoc J 129:406–410
Gremillon DH, Crawford GE (1981) Measles pneumonia in young adults. An analysis of 106 cases. Am J Med 71:539–542
Hansen WM, Glupczinski YG, Verstrecken L (1987)Kingella kingae septicaemia. Acta Clin Belg 42:40–42
Henriksen SD, Bovre K (1968)Moraxella kingii sp nov. a haemolytic, saccharolytic species of the genus Moraxella. J Gen Microbiol 51:377–385
Henriksen SD, Bovre K, Jonsson V (1976) Transfer of theMoraxella kingae Henriksen and Bovre to the genus Kingella gen. nov. in the family of the Neisseriaceae. Int J Syst Bacteriol 26:447–450
Hensey OJ, Coad N, Carty HM, Sills JM (1983) Juvenile discitis. Arch Dis Child 58:983–987
La Selve H, Berard J, Barbe G, Cochat N, Cochat P (1986) Ostéoarthrites et ostéomyélites àKingella kingae chez l'enfant. A propos de 5 observations et revue de la littérature. Pediatrie 4:294–304
Lasser AE, Goldmann EJ (1978) Moraxella bacteremia: report of a case resembling gonococcemia with cutaneous manifestations. Cutis 21:657–659
Lewis DA, Settas L (1983)Kingella kingae causing septic arthritis in Felty's syndrome. Postgrad med J 59:525–526
Lopez E, Dvonch V (1987) Discitis. Orthopedics 10:1476–1478
Mallet JF, Rigault P, Padovani JP, Pouliquen JC, Finidori G, Touzet P, Tanguy D (1984) Les cyphoses par spondylodiscites grave du nourrisson et du jeune enfant. Rev Chir Orthop 70:63–73
Morrison VA, Wagner KF (1989) Clinical manifestations ofKingella kingae infections: case report and review. Ref Infect Dis 11:776–783
Patel, NJ Moore TL, Wriss TD, Zuckner J (1983)Kingella kingae infectious arthritis: case report and review of literature of Kingella and Moraxella infections. Arthritis Rheum 26:557–559
Petrus M, Rance F, Clement JL, Prere MF, Ibanez MH, Netter JC (1990) Spondylodiscite àKingella kingae. Ann Pediatr (Paris) 37:170–172
Powell JM, Bass JW (1983) Septic arthritis caused byKingella kingae. Am J Dis Child 137:974–976
Prere MF, Seguy M, Vezard Y, Lareng MB (1986) Sensibilité aux antibiotiques deKingella kingae. Pathol Biol 34:604–607
Raymond J, Bergeret M, Bargy F, Missenard G (1986) Isolation of two strains ofKingella kingae associated with septic arthritis. J Clin Microbiol 24:1100–1101
Redfield DC, Overtuff GD, Ewing N, Powars D (1980) Bacteremia, arthritis, and skin lesions due toKingella kingae. Arch Dis Child 55:411–414
Rotbart HA, Gelfand WM, Glode MP (1984)Kingella kingae osteomyelitis of the clavicle. J Pediatr Orthop 4:500–502
Ryan MD, Taylor TKF (1987) Septic diskitis—a misnomer. Med J Austr 147:415
Salminen I, Von Essen R, Koota K, Nissinen A (1984) A pitfall in purulent arthritis brought out inKingella kingae infection of the knee. Ann Rheum Dis 43:656–657
Scoles PV, Quinn TP (1982) Intervertebral diskitis in children and adolescents. Clin Orthop 162:31–36
Shah MP, Miller CG (1984) Juvenile discitis (letter). Arch Dis Child 59:595–596
Shanson DC, Gazzard BG (1984)Kingella kingae septicemia with a clinical presentation resembling disseminated gonococcal infection. Br Med J 289:730–731
Shelton MM, Nachtigal MP, Yngve DA, Herndon WA, Riley HD (1988)Kingella kingae osteomyelitis: report of two cases involving the epiphysis. Pediatr Inf Dis J 7:421–424
Skouby SO, Knudsen FU (1982)Kingella kingae osteomyelitis mimicking an eosinophilic granuloma. Acta Pediatr Scand 71:511–512
Smith AF (1933) A benign form of osteomyelitis of the spine. JAMA 101:335–337
Snell JJP, Lapage SP (1976) Transfer of some saccharolytic Moraxella species to Kingella Henriksen and Bovre 1976, with descriptions of Kingella indologens sp. nov. and Kingella denitrificans sp. nov. Int J Syst Bacteriol 26:451–458
Spahr RC (1975) Septic arthritis due toMoraxella species. J Pediatr 86:310
Spiegel PG, Kengla KW, Isaacson AS, Wilson JC (1972) Intervertebral disc-space inflammation in children. J Bone Joint Surg 54:284–296
Toshniwal R, Draghi RC, Kocka FE, Kallick CA (1986) Manifestations of Kingella kingae infections in adults: resemblance to neisserial infections. Diagn Microbiol Infect Dis 5:81–85
Verbruggen AM, Hauglustaine D, Schildermans F, Hauwaert L van der, Rombouts JJ, Wauters G, Vandepitte J (1986) Infections caused by Kingella kingae: report of four cases and review. J Infect 13:133–142
Vincent J, Podewell C, Franklin GW, Korn JH (1981) Septic arthritis due toKingella (Moraxella) kingii. J Rheumatol 8: 501–503
Walterspiel JN (1983)Kingella kingae meningits with bilateral infarcts of the basal ganglia. Infection 11:307–309
Wong AS, Dyke J, Perry D, Anderson DC (1978) Paraspinal mass associated with intervertebral disk infection secondary toMoraxell kingii. J Pediatr 92:86–88
Woolfrey BF, Lally RT, Faville JR (1986) Intervertebral diskitis caused byKingella kingae. Am J Clin Pathol 85:745–749
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Lacour, M., Duarte, M., Beutler, A. et al. Osteoarticular infections due toKingella kingae in children. Eur J Pediatr 150, 612–618 (1991). https://doi.org/10.1007/BF02072618
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DOI: https://doi.org/10.1007/BF02072618