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Clinical presentations of Kingella kingae musculoskeletal infections in South Australian children.
Awwad, Elias; Tolley, Morgan; Antoniou, Georgia; Williams, Nicole.
Afiliação
  • Awwad E; Department of Orthopaedic Surgery and Paediatric Trauma Service, Women's and Children's Hospital, Adelaide, South Australia, Australia.
  • Tolley M; Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, South Australia, Australia.
  • Antoniou G; Department of Orthopaedic Surgery and Paediatric Trauma Service, Women's and Children's Hospital, Adelaide, South Australia, Australia.
  • Williams N; Department of Orthopaedic Surgery and Paediatric Trauma Service, Women's and Children's Hospital, Adelaide, South Australia, Australia.
J Paediatr Child Health ; 57(8): 1196-1200, 2021 08.
Article em En | MEDLINE | ID: mdl-33655677
AIM: This study aimed to alert clinicians to the spectrum of presentations of Kingella kingae musculoskeletal infections. METHODS: Between August 2010 and March 2018, 55 children presented with positive K. kingae polymerase chain reaction on joint fluid, bone or deep soft tissue collections involving the limbs and subsequently underwent retrospective medical record, radiological and laboratory review. Demographics and clinical information are presented. RESULTS: Median age at presentation was 15.9 months (range 4.3 months-10.7 years) and 64% were male. Septic arthritis was the most common diagnosis (95%), median duration of symptoms was 4 days, 65% had a preceding infection (e.g. upper respiratory or gastrointestinal) and 22% re-presented to emergency departments after prior discharge. The lower limb was involved in 84%, with the knee being most affected (55%). If the lower limb was involved, 82% of previously weight-bearing children had a limp or were unable to weight bear. On presentation, median temperature was 36.7°C and inflammatory markers were mildly elevated. No blood cultures grew K. kingae. Five synovial fluid cultures were positive for K. kingae. Plain radiography showed effusion, soft tissue swelling or a lesion in 53% of patients. All 41 ultrasounds showed effusion, soft tissue swelling or synovial thickening. One patient with delayed diagnosis later presented with avascular necrosis of the femoral head. CONCLUSION: Kingella kingae is difficult to diagnose due to non-specific symptoms, absence of fevers and often unremarkable blood tests. Despite generally having good long-term outcomes, our case of avascular necrosis suggests accurate diagnosis and treatment are important.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Infecciosa / Infecções por Neisseriaceae / Kingella kingae Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Oceania Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Infecciosa / Infecções por Neisseriaceae / Kingella kingae Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Oceania Idioma: En Ano de publicação: 2021 Tipo de documento: Article