{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:45:32Z","timestamp":1792442732510,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to alert clinicians to the spectrum of presentations of <jats:italic>Kingella kingae<\/jats:italic> musculoskeletal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between August 2010 and March 2018, 55 children presented with positive <jats:italic>K. kingae<\/jats:italic> polymerase chain reaction on joint fluid, bone or deep soft tissue collections involving the limbs and subsequently underwent retrospective medical record, radiological and laboratory review. Demographics and clinical information are presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age at presentation was 15.9\u00a0months (range 4.3\u00a0months\u201310.7\u2009years) and 64% were male. Septic arthritis was the most common diagnosis (95%), median duration of symptoms was 4\u2009days, 65% had a preceding infection (e.g. upper respiratory or gastrointestinal) and 22% re\u2010presented to emergency departments after prior discharge. The lower limb was involved in 84%, with the knee being most affected (55%). If the lower limb was involved, 82% of previously weight\u2010bearing children had a limp or were unable to weight bear. On presentation, median temperature was 36.7\u00b0C and inflammatory markers were mildly elevated. No blood cultures grew <jats:italic>K. kingae<\/jats:italic>. Five synovial fluid cultures were positive for <jats:italic>K. kingae<\/jats:italic>. Plain radiography showed effusion, soft tissue swelling or a lesion in 53% of patients. All 41 ultrasounds showed effusion, soft tissue swelling or synovial thickening. One patient with delayed diagnosis later presented with avascular necrosis of the femoral head.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>Kingella kingae<\/jats:italic> is difficult to diagnose due to non\u2010specific symptoms, absence of fevers and often unremarkable blood tests. Despite generally having good long\u2010term outcomes, our case of avascular necrosis suggests accurate diagnosis and treatment are important.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15422","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T09:16:19Z","timestamp":1614762979000},"page":"1196-1200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical presentations of <i>Kingella kingae<\/i> musculoskeletal infections in South Australian children"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3805-4752","authenticated-orcid":false,"given":"Elias","family":"Awwad","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Paediatric Trauma Service Women's and Children's Hospital  Adelaide South Australia Australia"},{"name":"Centre for Orthopaedic and Trauma Research University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Tolley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Paediatric Trauma Service Women's and Children's Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Antoniou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Paediatric Trauma Service Women's and Children's Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Paediatric Trauma Service Women's and Children's Hospital  Adelaide South Australia Australia"},{"name":"Centre for Orthopaedic and Trauma Research University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00028-14"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1099\/ijsem.0.001957"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3182755779"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.11.016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pit003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02649-15"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-014-0549-4"},{"key":"e_1_2_7_9_1","first-page":"170","article-title":"Clinical presentation and treatment of septic arthritis in children","volume":"61","author":"Moro\u2010Lago I","year":"2017","journal-title":"Rev. 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