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

Abstract

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.

Oropharyngeal Kingella kingae carriage in children: characteristics and correlation with osteoarticular infections

“…If so, OAI could result from the interaction of K. kingae colonization and acute URT infection (8)(9)(10)(11)(12)(13)(14). Recent studies have evidenced associations between viral respiratory diseases (32), such as primary herpetic gingiva-stomatitis (30), hand-foot-mouth disease/herpangina (33) and invasive K. kingae infections.…”

“…Most studies on oropharyngeal carriage of K. kingae have been among children of southern Israel, so these results may represent a regional epidemiologic phenomenon (8)(9)(10). The aim of this epidemiologic study was to determine the respiratory carriage of K. kingae among a Swiss population of healthy children aged from 7 to 48 mo using our K. kingae-specific rt-PCR, which is more sensitive than seminested broad-range 16S rRNA gene PCR, and standard culture in detecting K. kingae (11,12). Secondly, we investigated the age and seasonal distributions of K. kingae OAI as well as the correlation with its respiratory carriage.…”

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

“…The resulting amplification products are either sequenced and compared with sequences in the GenBank database or hybridized with organism-specific probes [28]. Some authors have reported detection of K. kingae from culture-negative specimens by using broad-range PCR amplification [54,55,83,98]. The use of the broad-range 16S rRNA gene assay offers the tremendous advantage of not requiring any a priori knowledge of the causative bacteria.…”

Kingella kingae: A Pediatric Pathogen of Increasing Importance

“…Other more rare syndromes caused by K. kingae include meningitis [42], ocular infections [43], pericarditis [44], and peritonitis [25].…”