Kingella kingae sternal osteomyelitis presenting as chest lump in a child

Abstract

Kingella kingae is a Gram-negative bacterium which belongs to the Neisseriaceae family. It is a facultative anaerobic, betahaemolytic, small bacillus that appears as pairs or short chains. It frequently colonises the oropharynx of infants and children from 6 to 48 months. It is often responsible for musculoskeletal infections in children and it has been reported as one of the most common causes of septic arthritis and osteomyelitis in children below 4 years of age. 1

Primary sternal osteomyelitis

“…1 Since then, 25 new cases have been reported, including the 2 cases described above. [3][4][5][6][7][8][9][10] Due to its low incidence, the rate of suspicion is low, which is often a reason for a delay in diagnosis and treatment.…”

“…8 The most frequently isolated microorganism is Staphylococcus aureus (40%), followed by K. kingae (16%) and Salmonella enteritidis (8%). 1,[3][4][5][6][7][8][9] An increase has been observed in cases caused by K. kingae (up to 30% in the past 5 years), especially in children under 3 years of age, probably due to the increased performance of new diagnostic techniques, such as polymerase chain reaction. 3,8,11 S. enteritidis causes infection primarily in children with sickle cell disease, although cases have recently been described in infants without hemoglobinopathy.…”

“…1,[3][4][5][6][7][8][9] An increase has been observed in cases caused by K. kingae (up to 30% in the past 5 years), especially in children under 3 years of age, probably due to the increased performance of new diagnostic techniques, such as polymerase chain reaction. 3,8,11 S. enteritidis causes infection primarily in children with sickle cell disease, although cases have recently been described in infants without hemoglobinopathy. 5 The performance of blood culture in primary sternal osteomyelitis is 30%, similar to that described in acute osteomyelitis in general.…”

Osteomielitis primaria de esternón

“…1 Desde entonces, se han publicado 25 nuevos casos, incluidos los 2 arriba descritos. [3][4][5][6][7][8][9][10] Por su baja incidencia, el índice de sospecha es bajo, lo que con frecuencia es motivo de demora en su diagnóstico y tratamiento.…”

“…8 El germen más frecuentemente aislado es Staphylococcus aureus (40 %), seguido de K. kingae (16 %) y Salmonella enteritidis (8 %). 1,[3][4][5][6][7][8][9] Se ha observado un aumento de los casos causados por K. kingae (hasta el 30 % en los últimos cinco años), especialmente en los niños menores de 3 años, probablemente debido al mayor rendimiento de nuevas técnicas diagnósticas, como la reacción en cadena de la polimerasa. 3,8,11 S. enteritidis causa la infección fundamentalmente en niños con anemia de células falciformes, aunque recientemente han sido descritos casos en lactantes sin hemoglobinopatía.…”