scholarly journals Kingella kingaeCausing Septic Arthritis of the Knee in anImmunocompetentAdult

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
J. Ricketts ◽  
N. N. T. Rehmatullah ◽  
P. Sutton
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Emerging Pathogen ◽  
Kingella Kingae ◽  
Immunocompetent Adult ◽  
Gram Negative ◽  
Delay In Diagnosis ◽  
Joint Infections ◽  
Isolation Techniques ◽  
Osteoarticular Infections

The bacteriumKingella kingaeis a species of Gram-negative coccobacillus usually found in the oropharynx. This is an emerging pathogen reported to cause bacteraemia, endocarditis, and osteoarticular infections in children and endocarditis in the immunocompromised adult. However, there are few cases of isolated joint infections reported in the immunocompetent adult. Due to specific isolation techniques required, delay in diagnosis can compromise patient outcome. We report a rare case of septic arthritis of the knee in an immunocompetent adult caused byK. kingae.

Rare case of Ureaplasma parvum septic arthritis in an immunocompetent patient

2020 ◽  
Vol 13 (9) ◽  
pp. e236396
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Next Generation ◽  
Ureaplasma Parvum ◽  
Urogenital Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Diagnostic Modalities

Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma. Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.

scholarly journals Kingella kingae Osteoarticular Infections Approached through the Prism of the Pediatric Orthopedist

2021 ◽  
Vol 10 (1) ◽  
pp. 25
Author(s):  
Giacomo DeMarco ◽  
Moez Chargui ◽  
Benoit Coulin ◽  
Benoit Borner ◽  
Christina Steiger ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Septic Arthritis ◽  
Surgical Procedures ◽  
Clinical Presentation ◽  
Tendon Sheath ◽  
Skeletal System ◽  
Kingella Kingae ◽  
Osteoarticular Infections ◽  
Acute Hematogenous Osteomyelitis ◽  
Mild Clinical Presentation

Nowadays, Kingella kingae (K. kingae) is considered as the main bacterial cause of osteoarticular infections (OAI) in children aged less than 48 months. Next to classical acute hematogenous osteomyelitis and septic arthritis, invasive K. kingae infections can also give rise to atypical osteoarticular infections, such as cellulitis, pyomyositis, bursitis, or tendon sheath infections. Clinically, K. kingae OAI are usually characterized by a mild clinical presentation and by a modest biologic inflammatory response to infection. Most of the time, children with skeletal system infections due to K. kingae would not require invasive surgical procedures, except maybe for excluding pyogenic germs’ implication. In addition, K. kingae’s OAI respond well even to short antibiotics treatments, and, therefore, the management of these infections requires only short hospitalization, and most of the patients can then be treated safely as outpatients.

scholarly journals Rare case of meningitis due to an emerging pathogen Chryseobacterium indologenes

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093609
Author(s):  
Anuj Sud ◽  
Monica Chaudhary ◽  
CP Baveja ◽  
PN Pandey
Keyword(s):  
Broad Spectrum ◽  
Rare Case ◽  
External Ventricular Drain ◽  
Gram Negative Bacteria ◽  
Wound Infections ◽  
Emerging Pathogen ◽  
Gram Negative ◽  
Chryseobacterium Indologenes ◽  
Immunosuppressed Patients

Chryseobacterium indologenes is a non-glucose fermenting Gram-negative bacteria widely distributed in nature. It has been found to cause a variety of infections like nosocomial pneumonia, bacteremia and wound infections usually in immunosuppressed patients and those with indwelling devices. The organism is resistant to a significant number of the commonly prescribed broad spectrum antibiotics. We report a rare case of meningitis due to C. indologenes in a patient diagnosed with medulloblastoma and hydrocephalus with an external ventricular drain in situ. The patient was successfully treated with trimethoprim/sulfamethoxazole combination and external ventricular drain replacement as shown by subsequent sterile cultures.

scholarly journals Isolated Septic Arthritis of the Hip Due to Fusobacterium nucleatum in An Immunocompetent Adult: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Masanori Nishi ◽  
Yasushi Yoshikawa ◽  
Yasutaka Kaji ◽  
Satoshi Okamoto ◽  
Katsunori Inagaki
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Joint Infection ◽  
Hip Osteoarthritis ◽  
Fusobacterium Nucleatum ◽  
Etiologic Agent ◽  
Perthes Disease ◽  
Two Stage ◽  
Immunocompetent Adult ◽  
History Of

Introduction: Hip septic arthritis is more common in children than in adults. Staphylococcus aureus and Streptococcus spp. are commonly found in association with septic joints. In contrast, Fusobacterium nucleatum septic arthritis in adults is extremely rare. To the best of our knowledge, only five cases have been reported in the literature in English, and three of them were cases of periprosthetic joint infection. We report a rare case of hip septic arthritis due to F. nucleatum in an immunocompetent adult. Case Presentation: A 56-year-old Asian man with a history of bilateral Perthes’ disease and mild alcoholic liver disease presented to our hospital complaining of worsening right hip pain and difficulty in walking for the previous 3 weeks. On presentation, his temperature was 38.7°C, and laboratory results showed a white blood cell count of 19 200 cells/µL and a C-reactive protein level of 43.56 mg/dL. Hip movements were limited due to pain. Contrast-enhanced computed tomography and magnetic resonance imaging showed fluid retention, suggesting infection. F. nucleatum was detected in the culture test from joint aspirate. Surgical drainage was performed 3 times in combination with antibiotherapy. Finally, we performed two-stage total hip arthroplasty, and the post-operative course was uneventful without implant loosening or infection relapse. Conclusion: The patient had a history of Perthes’ disease and had hip osteoarthritis, which may have contributed to the development of hip septic arthritis. We treated this rare case of hip septic arthritis due to F. nucleatum with two-stage revision surgery and antibiotherapy. Clinicians should be aware that F. nucleatum could be the etiologic agent of hip septic arthritis in an immunocompetent patient. Keywords: Septic Arthritis, Hip joint, Fusobacterium nucleatum, Adult

Real-Time PCR Assay for Detection of Kingella kingae in Children

2018 ◽  
Vol 13 (03) ◽  
pp. 216-223
Author(s):  
Theresa Madigan ◽  
Scott Cunningham ◽  
Poornima Ramanan ◽  
Micah Bhatti ◽  
Robin Patel
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Real Time ◽  
Real Time Pcr ◽  
Limit Of Detection ◽  
Toxin Gene ◽  
Pcr Assay ◽  
Kingella Kingae ◽  
The Real ◽  
Osteoarticular Infections

Background Kingella kingae is a known cause of osteoarticular infections in children younger than 4 years of age, but it is not always recoverable in culture. Molecular methods are increasingly used for diagnosis. Methods To facilitate diagnosis of K. kingae septic arthritis, we developed a real-time polymerase chain reaction (PCR) assay for the detection of K. kingae that targets the repeat-in-toxin gene (rtxB). Results We present three pediatric patients with K. kingae septic arthritis at our institution who were diagnosed using the real-time PCR assay. All underwent arthrotomy with irrigation and debridement and were symptom-free after 3 weeks of therapy with β-lactam antibiotics. Cultures of synovial fluid or tissue grew K. kingae in two of three; K. kingae real-time PCR was positive in all three patients. In addition, 11 cases of K. kingae osteoarticular infection were diagnosed through Mayo Medical Laboratories using this assay. The limit of detection of the real-time PCR assay was 73.7 colony-forming unit (CFU)/µL for tissue and 1.3 CFU/µL for synovial fluid. Conclusions PCR-based detection methods are faster and more sensitive than conventional culture-based methods for the diagnosis of K. kingae osteoarticular infections in children.

scholarly journals Native Joint Septic Arthritis due to Kingella kingae in an Adult

IDCases ◽  
2021 ◽  
pp. e01106
Author(s):  
Benjamin Chen ◽  
Takaaki Kobayashi ◽  
Hasan Samra ◽  
Poorani Sekar
Keyword(s):  
Septic Arthritis ◽  
Kingella Kingae

scholarly journals 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S236-S237
Author(s):  
Nanda Ramchandar ◽  
Jessica Burns ◽  
Andrew Pennock ◽  
Christopher R Cannavino ◽  
Lauge Farnaes
Keyword(s):  
Next Generation Sequencing ◽  
Septic Arthritis ◽  
Standard Care ◽  
Pediatric Population ◽  
Single Site ◽  
Acute Osteomyelitis ◽  
Next Generation ◽  
Pathogenic Organism ◽  
Osteoarticular Infections ◽  
Generation Sequencing

Abstract Background Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considered sterile. We sought to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Methods This was a single-site study to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Eligible patients were all patients with osteomyelitis or septic arthritis admitted to Rady Children’s Hospital from July 2019 through July 2020. We excluded any patients with bone or joint surgery within 30 days prior to admission. Operative samples were chosen at the surgeon’s discretion (joint aspirate, synovium, or bone) based on operative findings. We compared NGS testing to standard care culture from the same site. Results We enrolled 41 subjects. NGS of the operative samples identified a pathogen in 26 (63.4%) patients versus 18 (43.9%) by culture. Operative culture missed the diagnosis in 10 cases, though PCR identified the organism in 6 of those cases (5 were cases in which Kingella kingae was identified). In 4 subjects, NGS identified a putative organism where standard care testing (either PCR or culture) was negative. NGS was falsely positive in 1 subject and falsely negative for one other subject. Sensitivity was 96.3% (CI 95%, 81.0–99.9%) and Specificity was 92.9% (CI 95%, 66.1–99.8) for NGS versus 64.3% (CI 95%, 44.1–81.4) and 84.6% (CI 95%, 54.6–99.9%) for culture respectively. Conclusion In this single site prospective study of pediatric osteoarticular infections, we demonstrate improved sensitivity and specificity of NGS testing when compared to standard culture. Disclosures All Authors: No reported disclosures

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