Kingella kingae osteoarticular infections in children: eight new cases

Kingella kingae is a Gram-negative bacillus which belongs to the Neisseriac eae family. Its involvement in osteoarticular infections is relatively rece nt. Methods and results. - We report eight cases of Kingella kingae osteoarticu lar infections that have been diagnosed at the paediatric surgical centre o f Rouen University Hospital since October 1995. Six boys and two girls (mea n age: 30.6 months) presented with osteomyelitis in six cases and arthritis in two. Only 75% of patients had a fever at time of diagnosis. The biologi cal findings were slightly modified. All samples were obtained from blood, bone or joint fluid. These samples were systematically inoculated into a bl ood culture tube. Positive Kingella kingae culture was achieved in seven lo cal samples and in one blood culture. All children received two antibiotics via intravenous injection while waiting for the bacteriologic results. Lat er, the antibiotic treatment (amoxicilline) was given per os. The mean dura tion of treatment was 33 days. Patients were given intravenous treatment fo r a period of only ten days. Six patients were followed up for a period of more than 18 months and outcome was always uneventful. Discussion. - Kingella kingae is usually present in the nasopharyngeal muco sa and spreads in the blood due to various infections. Different types of K ingella kingae infection have been reported with a large frequency of osteo articular infection. Conclusion. - This type of infection does not present any unusual character istics as compared to other osteoarticular infections. Because of its antib iotic sensitivity treatment duration could be reduced. Kingella kingae is a fragile microbe and its culture is often difficult; therefore, it is impor tant to use blood culture tubes to inoculate joint fluid and bone samples. (C) 2000 Editions scientifiques et medicales Elsevier SAS.