Kingella kingae infections in children

Objective: To increase awareness of Kingella kingae infections in children by presenting four cases seen at the Gold Coast Hospital, Southport, Queensland, and reviewing the literature. Methodology: Records of the four cases were reviewed and relevant information described. A MEDLINE search of the English literature from 1983 to 1998 was conducted. Results: Osteoarticular infections are the commonest type of invasive paediatric infection but bacteraemia and endocarditis also occur. Isolation of the organism is difficult but inoculation of the specimen into enriched blood culture systems improves the recovery rate. The majority of isolates are sensitive to beta-lactam antibiotics but resistance has been described. Conclusions: Kingella kingae infections in children are more common than previously recognized. The organism should be actively sought in any child with suspected osteoarticular infections. Recommended empiric therapy is a third generation cephalosporin until susceptibility to penicillin is confirmed.