Half a century of Kingella kingae: a literature review from a pediatric rheumatology perspective
DOI:
https://doi.org/10.2478/AMB-2026-0075Keywords:
Kingella kingae, pediatric rheumatology, osteomyelitis, septic arthritis, spondylodiscitisAbstract
Abstract. Objective: To review the current knowledge on Kingella kingae infections in children from a pediatric rheumatology perspective, focusing on epidemiology, pathogenesis, clinical features, diagnostic methods, and treatment strategies. Materials and methods: A literature search was conducted using PubMed and Google Scholar (2010–2025) with key words including “Kingella kingae”, “pediatric rheumatology”, “osteomyelitis”, “septic arthritis”, “spondylodiscitis”, and “diagnostic techniques”. Studies were selected based on clinical relevance, methodological quality, and contribution to understanding pediatric Kingella kingae infections, prioritizing recent reviews, original research, clinical guidelines, and seminal historical studies. Results: Kingella kingae has become a leading cause of osteoarticular infections in children under four years, often presenting with mild or afebrile symptoms and modest inflammatory markers. It can cause septic arthritis, osteomyelitis, spondylodiscitis, and tenosynovitis. Advances in nucleic acid amplification assays have improved detection over traditional culture methods. The RtxA toxin and outer membrane vesicles play key roles in pathogenicity. β-lactam antibiotics are highly effective, with short-course regimens increasingly favored. Remaining challenges include diagnostic delays, limited access to molecular testing, and a lack of standardized treatment guidelines. Conclusion: Early recognition of Kingella kingae infections is essential to prevent morbidity. Pediatric rheumatologists and orthopedics should maintain a high index of suspicion in children aged 6-48 months with subtle musculoskeletal symptoms. Further research is needed to refine diagnostic algorithms, optimize antibiotic regimens, and understand regional epidemiological variations.
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