1. Paediatric Infectious Diseases Unit, Hospital Dona Estefânia – Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
2. Paediatric Orthopaedics Unit, Hospital Dona Estefânia – Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
3. Imaging Department, Hospital Dona Estefânia – Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal
Pediatrics International (2016) 58, 244–245 (Letter to the Editor)
Kingella kingae has emerged as an important cause of osteoarticular infections (OAI) in young children. Usually these infections are mild and have a favorable prognosis, however severe infections have been recently reported. We discuss 3 cases of previously healthy children between 2 and 3 years-old with these atypical lesions, showing unifocal bony lytic lesions in the lower limb (talus, calcaneus and peroneus), growth cartilage damage and articular effusion, besides their mild clinical presentation and low inflammatory markers. All were submitted to surgical treatment and initial empirical intravenous antibiotherapy with flucloxacillin and gentamycin, soon changed for amoxicillin-clavulanate or cefuroxime after the identification of K. kingae in bone aspirate/synovial fluid cultures. There was a rapid clinical and laboratorial response and neither acute or chronic complication, nor recurrence, was reported. Most likely, the indolent and low virulence nature of the bacteria explains this favorable outcome. Nevertheless, we shouldn´t underestimate the potential risk of K. kingae OAI.
Palavras-chave: Kingella kingae, osteoarthritis infection, lytic, children