de Groot R, Glover D, Clausen C, Smith A L, Wilson C B
Sophia Children's Hospital, Rotterdam, The Netherlands.
Rev Infect Dis. 1988 Sep-Oct;10(5):998-1004. doi: 10.1093/clinids/10.5.998.
Six cases of Kingella kingae arthritis, osteomyelitis, and diskitis were studied, and data were reviewed from an additional 23 cases in the English-language literature. K. kingae is a slow-growing, fastidious, gram-negative microorganism that colonizes mucous membranes of the upper respiratory tract. Infections were predominantly seen in infants and young children (86% of cases) and were preceded by an upper respiratory tract infection in 31% of patients. Low-grade fever (38 degrees C-39 degrees C) and pain or swelling involving the affected limb developed insidiously. However, 76% of the infections were diagnosed within 1 week after the onset of symptoms. The knee was involved in 47% and the hip in 33% of cases of arthritis. Osteomyelitis mainly involved the femur (36%); four cases of osteomyelitis (29%) were diagnosed as diskitis. The erythrocyte sedimentation rate was greater than 20 mm/h in all patients. Gram stains of aspiration fluid were positive in 19% of cases, whereas blood cultures yielded growth in only 5%. Radiographic signs indicating the presence of osteomyelitis were observed in 93% of patients. All patients recovered completely. K. kingae is an important causative agent in indolent bone, joint, and intervertebral disk infections.
对6例金氏金杆菌性关节炎、骨髓炎和椎间盘炎进行了研究，并回顾了英文文献中另外23例病例的数据。金氏金杆菌是一种生长缓慢、苛求营养的革兰氏阴性微生物，可在上呼吸道粘膜定植。感染主要见于婴幼儿（占病例的86%），31%的患者在感染前有上呼吸道感染。低热（38℃-39℃）以及受累肢体的疼痛或肿胀逐渐出现。然而，76%的感染在症状出现后1周内得到诊断。关节炎病例中，47%累及膝关节，33%累及髋关节。骨髓炎主要累及股骨（36%）；4例骨髓炎（29%）被诊断为椎间盘炎。所有患者的红细胞沉降率均大于20mm/h。抽吸液的革兰氏染色在19%的病例中呈阳性，而血培养仅5%培养出细菌。93%的患者观察到提示骨髓炎存在的影像学征象。所有患者均完全康复。金氏金杆菌是隐匿性骨、关节和椎间盘感染的重要病原体。
