COMMENTARY

Septic Arthritis in a 14-Month-Old Child

Jeanette M. Ramos, MD; Julie A. Ribes, MD, PhD

Disclosures

April 12, 2010

In This Article

Treatment and Prognosis

K kingae isolates have been found to have relatively homogeneous antibiotic susceptibility patterns. Evaluation of 145 isolates from Israel demonstrated universal susceptibility to erythromycin, gentamicin, chloramphenicol, tetracycline, and ciprofloxacin. All of the isolates tested were negative for beta-lactamase production and had low minimum inhibitory concentrations (MICs) to penicillin. Nearly 40% of isolates, however, were resistant to clindamycin.[20] In a 2004 review of the literature, Yagupsky found published evidence of occasional resistance to erythromycin, ciprofloxacin, and co-trimoxazole and complete resistance to vancomycin and trimethoprim. Beta-lactamase had been found in 4 isolates.[4] In an outbreak of infections seen in an Israeli daycare center, all of the isolates were resistant to clindamycin and the MIC for penicillin ranged from 4 µg/mL to 94 µg/mL with a median value of 32 µg/mL.[17] Treatment generally includes 1 or more weeks of intravenous (IV) antibiotics and may be followed with several weeks of oral antibiotic therapy. Some patients' symptoms, however, will resolve without antibiotic therapy.[10]

The prognosis for joint infections with K kingae is generally good. Many of the cases are mild and may resolve without any interventions. Surgery is not indicated in most cases.[10]

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