Journal article
Imaging of Kingella kingae musculoskeletal infections in children: a series of 5 cases
Emergency radiology, Vol.25(6), pp.615-620
12/2018
DOI: 10.1007/s10140-018-1617-8
PMID: 29909593
Abstract
Kingella kingae musculoskeletal infections continue to be under-diagnosed and there remains a paucity of literature on its imaging features. The purpose of this manuscript is to review the imaging, clinical, and laboratory findings of microbiology-proven K. kingae infections.
A retrospective review of musculoskeletal infections between January 1, 2013 and Dec 31, 2016 yielded 134 patients from whom 5 patients had confirmed K. kingae infections (3 boys and 2 girls, mean age of 16 months, range 9-38 months). Picture archiving and communication system and electronic medical records were reviewed.
At presentation, none of the patients had a fever and not all patients had abnormal inflammatory markers. Three patients had septic arthritis (2 knee and 1 sternomanubrial joints), one had epiphyseal osteomyelitis, and one had lumbar spondylodiscitis. The case of epiphyseal osteomyelitis of the distal humerus also had elbow joint involvement. A combination of radiography (n = 4), ultrasound (n = 2), and magnetic resonance (MR) imaging (n = 5) were performed. Prominent synovial thickening was observed for both knee and elbow joints and extensive regional myositis for all except for the patient with sternomanubrial joint infection. The diagnosis of K. kingae infection resulted in a change in the antibiotic regimen in 80% of the patients.
Disproportionate synovial thickening, prominent peri-articular myositis, and/or characteristic sites of involvement demonstrating imaging features of infection or inflammation in a young child with mild infectious symptoms and elevated inflammatory markers should invoke the possibility of an underlying K. kingae infection.
Details
- Title: Subtitle
- Imaging of Kingella kingae musculoskeletal infections in children: a series of 5 cases
- Creators
- Jie C Nguyen - Department of Radiology, 3NW39, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. jiec29@gmail.comSusan L Rebsamen - Department of Radiology, CSC, MC 3252, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-3252, USAMichael J Tuite - Department of Radiology, CSC, MC 3252, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-3252, USAJ Muse Davis - Department of Infectious Diseases, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-3252, USAHumberto G Rosas - Department of Radiology, CSC, MC 3252, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-3252, USA
- Resource Type
- Journal article
- Publication Details
- Emergency radiology, Vol.25(6), pp.615-620
- DOI
- 10.1007/s10140-018-1617-8
- PMID
- 29909593
- ISSN
- 1070-3004
- eISSN
- 1438-1435
- Language
- English
- Date published
- 12/2018
- Academic Unit
- Stead Family Department of Pediatrics; Infectious Disease (Pediatrics)
- Record Identifier
- 9984093365702771
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