LQCL2511 - CMLE - Kingella kingae Septic Arthritis in a Pediatric Patient-LQCL2511

LQCL2511 - Educational Activity

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The document details a case study and discussion on Kingella kingae (K. kingae), a gram-negative bacillus primarily known for causing bone and joint infections in children under four years of age. K. kingae infections usually occur due to the organism being resident microbiota of the oropharyngeal mucosa. Transmitted through respiratory droplets, poor dentition, or oral trauma, it is a leading cause of septic arthritis and osteomyelitis in children. The document presents a case of a 15-month-old with K. kingae septic arthritis diagnosed by culture and treatment with appropriate antibiotics.<br /><br />Key points include the recognition and characteristics of K. kingae infections, diagnosis, and treatment strategies. Laboratory techniques for identifying K. kingae emphasize the use of both nucleic acid amplification tests (NAAT) and traditional cultures, recommending the incubation for up to five days to improve detection. Oxidase positive and catalase negative, K. kingae requires specific media for optimal growth, and culture-independent methods like NAAT tests can provide quicker results. However, some limitations include an inability to perform susceptibility testing. While many K. kingae isolates are susceptible to various antibiotics, production of beta-lactamase in some isolates underscores the importance of careful antimicrobial selection.<br /><br />The patient in the case study was treated with ampicillin/sulbactam and later switched to oral cephalexin. This treatment successfully resolved symptoms. The study underscores the need for accurate microbiologic diagnosis to manage septic arthritis effectively in children and details the importance of recognizing K. kingae's growing role in pediatric infections traditionally attributed to other bacteria such as Staphylococcus aureus.

Keywords

Kingella kingae

septic arthritis

osteomyelitis

pediatric infections

nucleic acid amplification tests

antibiotic treatment

beta-lactamase

microbiologic diagnosis

oropharyngeal mucosa

respiratory transmission