Infection multifocale invasive à Kingella kingae

Sarda, H; Ghazali, Daniel Aiham; Thibault, M.; Leturdu, Françoise; Adams, Catherine; Loch, H.

doi:10.1016/s0929-693x(97)86830-3

Cited by 22 publications

(15 citation statements)

References 11 publications

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“…Recent or concomitant rhinorrhea, pharyngitis, stomatitis, or diarrhea is noted in the majority of cases (102). With the exception of patients with endocardial involvement who develop embolic phenomena (21,132,138), a single body system is usually affected.…”

Section: Clinical Features Of K Kingae Diseasementioning

confidence: 99%

“…Antecedent poor dental hygiene (243) or dental extractions (244) have been reported in adolescents and adult patients. A native valve is af-fected in 95% of children (138,168,(245)(246)(247)(248)(249)(250)(251)(252), whereas native (133,245,(252)(253)(254)(255) and prosthetic (21,23,243,(256)(257)(258)(259) valve involvement have been reported with approximately similar frequency in adult patients. The mitral valve is affected in over 90% of cases (113,124,130,133,168,244,245,247,248,250,252,255,257,(260)(261)(262)(263)(264)(265)(266), followed by the aortic valve (6, 23, 243, 246, 249, 253-256, 259, 267, 268), while tricuspid (269) or pulmonary …”

Section: Endocarditismentioning

confidence: 99%

“…Despite K. kingae's remarkable susceptibility to antimicrobial drugs, serious complications, such as embolism or mycotic aneurism to the femoral (9,130,251), brachial (124), or ophthalmic (9) arteries, valvular insufficiency (113,242,245,247,249,250,264,269), congestive heart failure (133,249,272) or cardiogenic shock (21,130,258), pulmonary infarction (269), mitral valve rupture (244) or perforation (242,250,263), paravalvular abscess formation (249,259,265), cerebrovascular accidents (113, 168, 242, 255, 257, 261-263, 265, 266, 272, 273), meningitis (113,138,242,245), brain abscess (251), and embolic arthritis (138) and cellulitis (252), are common. Emergency cardiac surgery has been prescribed for life-threatening complications that do not respond to conservative medical treatment (9, 130, 244, 248-250, 259, 263, 267, 271, 272), many patients require late valvuloplasty (269) or valve replacement (242,247,259), and the overall mortality rate of the disease is Ͼ10% (9,18,…”

Section: Endocarditismentioning

confidence: 99%

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Kingella kingae: Carriage, Transmission, and Disease

2015

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SUMMARY Kingella kingae is a common etiology of pediatric bacteremia and the leading agent of osteomyelitis and septic arthritis in children aged 6 to 36 months. This Gram-negative bacterium is carried asymptomatically in the oropharynx and disseminates by close interpersonal contact. The colonized epithelium is the source of bloodstream invasion and dissemination to distant sites, and certain clones show significant association with bacteremia, osteoarthritis, or endocarditis. Kingella kingae produces an RTX (repeat-in-toxin) toxin with broad-spectrum cytotoxicity that probably facilitates mucosal colonization and persistence of the organism in the bloodstream and deep body tissues. With the exception of patients with endocardial involvement, children with K. kingae diseases often show only mild symptoms and signs, necessitating clinical acumen. The isolation of K. kingae on routine solid media is suboptimal, and detection of the bacterium is significantly improved by inoculating exudates into blood culture bottles and the use of PCR-based assays. The organism is generally susceptible to antibiotics that are administered to young patients with joint and bone infections. β-Lactamase production is clonal, and the local prevalence of β-lactamase-producing strains is variable. If adequately and promptly treated, invasive K. kingae infections with no endocardial involvement usually run a benign clinical course.

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Section: Clinical Features Of K Kingae Diseasementioning

confidence: 99%

Section: Endocarditismentioning

confidence: 99%

Section: Endocarditismentioning

confidence: 99%

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Kingella kingae: Carriage, Transmission, and Disease

2015

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“…However, serious lifethreatening complications may happen, such as destruction of heart valves, cardiac failure, septic shock, mycotic aneurisms and cerebrovascular accidents, and the overall mortality rate remains high, at approximately 15% [18,28,56,58,63,[65][66][67][68][69]. For these reasons, echocardiographic evaluation of patients from whom the organism is isolated from a normally sterile site, especially blood, has been recommended by a few authors [70]. Bacterial endocarditis is strongly associated with future science group clone P organisms, which are seldom carried asymptomatically and are rare in other infected sites [20,24].…”

Section: Bacterial Endocarditismentioning

confidence: 99%

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

et al. 2013

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Kingella kingae is a Gram-negative bacterium that is today recognized as the major cause of joint and bone infections in young children. This microorganism is a member of the normal flora of the oropharynx, and the carriage rate among children under 4 years of age is approximately 10%. K. kingae is transmitted from child to child through close personal contact. Key virulence factors of K. kingae include expression of type IV pili, Knh-mediated adhesive activity and production of a potent RTX toxin. The clinical presentation of K. kingae invasive infection is often subtle and may be associated to mild-to-moderate biologic inflammatory responses, highlighting the importance a high index of suspicion. Molecular diagnosis of K. kingae infections by nucleic acid amplification techniques enables identification of this fastidious microorganism. Invasive infections typically respond favorably to medical treatment, with the exception of cases of endocarditis, which may require urgent valve replacement

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“…In this population, it is considered the second most common cause of septic arthritis, with almost 12% of documented cases of arthritis caused by this pathogen (6). A few other reports in pediatric settings include discitis, osteomyelitis, and infections of the central nervous system (1,5,13).…”

Section: Case Reportmentioning

confidence: 99%

Molecular Diagnosis of Kingella kingae Pericarditis by Amplification and Sequencing of the 16S rRNA Gene

et al. 2007

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Kingella kingae is a fastidious gram-negative bacillus that is considered an emerging pathogen in pediatric settings but remains less common in adults. Here we describe a case of pericarditis in an immunocompetent adult host. The microorganism was identified directly from the clinical sample by molecular techniques, i.e., 16S rRNA gene amplification and sequencing. CASE REPORTIn December 2006, a 43-year-old woman was admitted to our hospital for dyspnea and fever. The patient had no significant medical history. A week before admission, she had complained of fever with a sore throat and was treated with 1 g of amoxicillin (three times a day) for 5 days without improvement. She was then admitted for dyspnea. The clinical exam was unremarkable except for a temperature of 38.2°C and reduced breath sounds in the left lung base. The leukocyte count was 16,300/mm 3 (absolute neutrophil count, 11,200/mm 3 ), and the hemoglobin level was 10 g/dl. The C-reactive protein (CRP) was markedly elevated at 308 mg/ liter (normal level, Ͻ10 mg/liter), and the liver enzyme levels were twice the normal range. The patient was hypoxic, with an arterial partial pressure of oxygen equal to 59 mm Hg. A chest X-ray showed enlargement of the cardiac silhouette, and an elevation of the ST segment (the time between the end of the ventricle's depolarization and the beginning of repolarization) compatible with pericarditis was noted on the electrocardiogram. Transthoracic echocardiography was rapidly performed and revealed a circumferential pericardial effusion with tamponade.

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Infection multifocale invasive à Kingella kingae

Cited by 22 publications

References 11 publications

Kingella kingae: Carriage, Transmission, and Disease

Kingella kingae: Carriage, Transmission, and Disease

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

Molecular Diagnosis of Kingella kingae Pericarditis by Amplification and Sequencing of the 16S rRNA Gene

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