<i>Kingella kingae</i>Causing Septic Arthritis of the Knee in an<i>Immunocompetent</i>Adult

Ricketts, James; Rehmatullah, Nader; Sutton, Paul M.

doi:10.1155/2015/519190

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…kingae usually causes septic arthritis in early childhood (1), but has been rarely reported in adults; only 10 such cases were identified in a literature review by using PubMed, Google, and Google Scholar and the words "Kingella kingae," "adult," and "arthritis." Previous reports included both male and female patients, of the entire adult age range, and in both immunosuppressed and immunocompetent patients (3)(4)(5)(6)(7)(8). Other reported rare infections with K. kingae in adults include peritonitis (9), keratitis (10,11), stomatitis (12), urinary tract infection (13), and bacteremia (14).…”

Section: Resultsmentioning

confidence: 99%

Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient

Mustafa-Hellou¹,

Sagi²,

Ofran³

et al. 2020

Emerg. Infect. Dis.

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K ingella kingae, a gram-negative coccobacillus, might be part of the normal flora of the upper respiratory tract. It is a well-recognized causative agent of osteoartricular infections in children <4 years of age (1). In adults, it rarely causes infections; the most well-known is infective endocarditis as part of the HACEK (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) group. Predisposing factors for K. kingae infection are poor oral hygiene, pharyngitis, and mucosal ulcerations (2). Few cases of isolated septic arthritis in immunocompetent and immunocompromised adult patients had been described. We report a rare case of endovascular infection caused by K. kingae in an immunocompromised adult patient in Israel who had septic arthritis.

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Section: Resultsmentioning

confidence: 99%

Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient

Mustafa-Hellou¹,

Sagi²,

Ofran³

et al. 2020

Emerg. Infect. Dis.

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“…Yagupsky described osteoarticular infection as the most common manifestation of invasive K. kingae infection, occurring in 62.4 % (53 of 85) of cases among children in a large referral center in Israel from 1988 to 2002 [ 1 ]. The first case of K. kingae native joint septic arthritis in an otherwise healthy adult was described by Esteve et al in 2001 [ 3 ], with a second case described by Ricketts et al in 2015 [ 4 ]; both cases involved the knee. A review of the English language literature demonstrates cases of K. kingae osteoarticular infection in adults with severe rheumatoid arthritis with Felty’s syndrome [ 5 ] and recent upper respiratory infection [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The optimal antimicrobial treatment duration for K. kingae septic arthritis is even less understood, owing to the inherent rarity of the condition. Previous cases of K. kingae septic arthritis in adults were successfully treated with anywhere from 10 days to 3 months of oral or parenteral antibiotics, with or without surgical washout [ [3] , [4] , [5] , [6] ]. Our patient was successfully treated with surgical debridement and four weeks of ceftriaxone, with improvement in both clinical symptoms as well as laboratory values.…”

Section: Discussionmentioning

confidence: 99%

Native joint septic arthritis due to Kingella kingae in an adult

Chen

Kobayashi

Samra

et al. 2021

IDCases

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A 65-year-old woman with chronic osteoarthritis of the knees presented with a one-week history of acutely worsening right knee pain and swelling. Arthrocentesis was performed and synovial fluid was indicative of septic arthritis with a negative Gram stain for bacteria. Magnetic Resonance Imaging (MRI) was obtained, revealing a large anterior periarticular abscess with concomitant septic arthritis. Orthopedic surgeons performed urgent incision and drainage of the abscess and washout of the joint. Synovial fluid culture grew Kingella kingae and the patient was treated with four weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. Kingella kingae is a common cause of pediatric bone and joint infection but remains an exceedingly rare cause of native joint septic arthritis among immunocompetent adults. Kingella spp are largely susceptible to beta-lactam antimicrobials.

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“…The "H" represents Haemophilus; the "A" represents Aggregatibacter, previously Actinobacillus; the "C" represents Cardiobacterium; the "E" represents Eikenella; and the "K " represents Kingella. Each of these microorganisms can also cause pyogenic arthritis [5][6][7][8][9][10][11]. A recently published review of native joint septic arthritis found members of the HACEK group to be the primary pathogen in 27 of 436 (6.2%) infected native joints [12].…”

Section: Introductionmentioning

confidence: 99%

Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

Otchere¹,

Seif²,

Myers³

2022

PPID

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Introduction. The Cardiobacterium species is a pleomorphic Gram-negative bacterium discovered in 1964 and is part of the HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella) group of organisms known to cause endocarditis. It has low virulence and can also cause dacryocystitis, septicemia and abdominal abscess. We report a patient with C. hominis prosthetic joint infection in the absence of definitive endocarditis. Case Report. A 57-year-old man presented to his orthopedic surgeon 17 months after left total knee arthroplasty with a 4–5-day history of left knee pain following yard work. He had an aortic valve replacement in 2003, mitral valve repair in 2006 and bovine aortic valve replacement in 2019 (12 months previously). Aspirate of knee joint fluid was grossly cloudy. Two of two preoperative blood cultures revealed Cardiobacterium species after 4 days’ incubation. He was initially treated with intravenous vancomycin plus piperacillin/tazobactam followed by 6 weeks of parenteral ceftriaxone followed by five months of oral cefdinir. Patient is infection-free 6 months after completion of antimicrobial therapy. Discussion. Cardiobacterium hominis is a slow-growing, fastidious, capnophilic, Gram-negative bacillus commonly found in normal oral and upper respiratory flora. Google Scholar™ and PubMed®searches were conducted and this is the first reported case of prosthetic joint infection due to Cardiobacterium hominis. We found three previously reported cases of C. hominis pyogenic arthritis: one patient with native knee pyogenic arthritis, one patient with cervical spondylodiscitis and one patient with lumbar spondylodiscitis and epidural abscess. Two of these three patients had TEE-documented infective endocarditis and one had a bioprosthetic aortic valve without evident vegetation on TEE. Our patient had a bioprosthetic aortic valve without TEE evidence of endocarditis. C. hominis should be added to the list of organisms that can cause bacteremically spread prosthetic joint infection.

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Kingella kingaeCausing Septic Arthritis of the Knee in anImmunocompetentAdult

Cited by 3 publications

References 22 publications

Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient

Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient

Native joint septic arthritis due to Kingella kingae in an adult

Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

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