Clinical features and epidemiology of invasive Kingella kingae infections in southern Israel.

Abstract:

OBJECTIVE:To characterize the clinical spectrum and epidemiology of invasive Kingella kingae infections in children living in southern Israel. DESIGN:Five-year observational, descriptive study. POPULATION:Children in whom K. kingae was isolated from blood or other normally sterile body fluid. RESULTS:Twenty-five patients with invasive K. kingae infection (13 male and 12 female) were identified. Twenty-four of these children were younger than 2 years. The annual incidence was 14.3, 27.4, and 31.9 cases per 100,000 children < or = 4 years, < or = 24 months, and < or = 12 months, respectively. Seventeen (68%) of 25 patients sought treatment between July and December. Concomitant upper respiratory tract infection or stomatitis was observed in 14 (56%) of the patients, suggesting a respiratory or buccal source for the infection. Four children were bacteremic: 2 of them suffered from a lower respiratory tract infection, and the remaining 2 had bacteremia with no evident focal infection. Twenty-one children had skeletal infections and none of them was bacteremic; 16 had septic arthritis, 3 had osteomyelitis, 1 had both osteomyelitis and septic arthritis of the adjacent joint, and 1 had dactylitis of the hand. Involvement of the ankle was unusually frequent among children with septic arthritis, whereas the calcaneus was involved in 3 of the 4 children with osteomyelitis. Antibiotic treatment resulted in full recovery in all cases, and only 2 patients with septic arthritis required surgical drainage. CONCLUSION:Kingella kingae is a much more common cause of invasive infection in young children than has been previously recognized. The disease has a clear seasonal pattern, usually affects the skeletal system, frequently involves unusual bones and joints, and follows a benign course.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Yagupsky P,Dagan R,Howard CB,Einhorn M,Kassis I,Simu A

subject

Has Abstract

pub_date

1993-12-01 00:00:00

pages

800-4

issue

6

eissn

0031-4005

issn

1098-4275

journal_volume

92

pub_type

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