1 - Pediatria Médica, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Ortopedia Pediátrica, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
3 - Radiologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
4 - Infeciologia Pediátrica, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- 40th Annual Meeting of the European Society For Paediatric Infectious Diseases (ESPID 2022)
- Poster
Background: Subacute osteomyelitis (SAO) is an insidious infection difficult to diagnose. Recently, K. kingae has been identified as a common etiological agent in young children.
Aim: The aim is to characterize K. kingae SAO in children admitted to a tertiary care hospital.
Methods: Longitudinal observational study of children with K. kingae SAO admitted to a tertiary care paediatric hospital over an 8-year period (2013-2020). The parameters included demographics, clinical data, treatment, and disease progression.
Results: 10 children (17.2% of all K. kingae infections) with a male to female ratio of 1,5:1 and a median age of 24 months, IQR 24 (12-36). The most common symptoms were functional impairment and pain, with only three (30%) presenting with fever. The median duration of symptoms was 21 days (IQR 10.5). Involvement of the lower extremities (70%) was more frequent, often at the tarsal bones (40%), and 50% had concurrent septic arthritis. Seven had intraosseous abscess, three epiphyseal involvement, three chondritis, and three concomitant tenosynovitis. All blood cultures were negative. Bone cultures were positive in 3/5 patients. K. kingae PCR was positive in 8 patients: bone (2/2), synovial fluid (2/2), oropharyngeal swab (8/8, in 4 patients was the only positive test). Cefuroxime and amoxicillin-clavulanate were used for treatment, with a median duration of 28 days (IQR 9). Surgical intervention was performed in 60%: bone drainage (2), punction (2), and arthrocentesis (2). No sequelae were observed and all osteolytic lesions disappeared with complete bone reconstruction.
Discussion: K. kingae SAO is an important cause of osteoarticular infections in young children. These infections have a benign course. Shorter antibiotic courses and less surgical interventions are also safe and effective.
Palavras Chave: Child, Kingella kingae, Osteomyelitis