Detection by Culture

Cure Arthritis Naturally

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In the late 1980's, pediatricians working at the Soroka University Medical Center (SUMC) in southern Israel decided to inoculate synovial fluid aspirates from patients with presumptive septic arthritis into blood culture vials, in an attempt to improve the bacteriological diagnosis (Yagupsky et al., 1992). Shortly after the adoption of this unorthodox approach, a Gram-negative coccobacillus growing in pairs or short chains was detected in several blood culture vials seeded with joint exudates of young children (Figure 15.1). Based on the characteristic Gram stain, 6-hemolysis production, positive oxidase test, and glucose and maltose utilization, the organism was identified as Kingella kingae, an obscure bacterium first described by Elizabeth King in the 1960's, and rarely isolated from patients with skeletal system infections or endocarditis (Henriksen and B0vre, 1968).

Attempts to isolate the organism from synovial fluid exudates seeded onto routine solid media succeeded in only 2 of 12 patients, whereas inoculation of these specimens into aerobic blood culture vials yielded, after a median incubation of 4 days, K. kingae in all cases. When the positive blood culture vials were then sub-cultured onto blood-agar plates, K. kingae grew without difficulties, demonstrating that routine solid media are able to support its nutritional requirements. It is postulated that pus exerts an inhibitory effect upon K. kingae, and that decreasing the concentration of detrimental factors by diluting the specimen in a large broth volume

Figure 15.1. Gram stain of K. kingae showing short gram-negative rods with tapered ends arranged in pairs or short chains. Reprinted from Lancet Infectious Diseases, Vol 4, Yagupsky et al., "Kingella Kingae: from medical rarity to an emerging paediatric pathogen," 332-41, 2004, with permission from Elsevier.

Figure 15.1. Gram stain of K. kingae showing short gram-negative rods with tapered ends arranged in pairs or short chains. Reprinted from Lancet Infectious Diseases, Vol 4, Yagupsky et al., "Kingella Kingae: from medical rarity to an emerging paediatric pathogen," 332-41, 2004, with permission from Elsevier.

is a key factor in improving the recovery of the organism (Yagupsky et al., 1992; Yagupsky, 2004).

When synovial fluid specimens were systematically inoculated into blood culture vials, K. kingae appeared as the most common etiology of septic arthritis in Israeli children younger than 2 years, causing half of all culture-proven cases (Yagupsky et al., 1995a). This observation has been confirmed in France (Moumile et al., 2003; Moumile et al., 2005) and the USA (Lundy and Kehl, 1998; Luhmann and Luhmann, 1999; Moylett, 2000) indicating that K. kingae is a much more common pathogen that it has been traditionally appreciated.

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Arthritis Joint Pain

Arthritis Joint Pain

Arthritis is a general term which is commonly associated with a number of painful conditions affecting the joints and bones. The term arthritis literally translates to joint inflammation.

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