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Volume 27, Number 3—March 2021
Synopsis

Clinical Features and Comparison of Kingella and Non–Kingella Endocarditis in Children, Israel

Alexander Lowenthal1, Hila Weisblum-Neuman1, Einat Birk, Liat Ashkenazi-Hoffnung, Itzhak Levy, Haim Ben-Zvi, Gabriel Amir, Georgy Frenkel, Elchanan Bruckheimer, Havatzelet Yarden-Bilavsky, Dafna Marom, Eran Shostak, Elhanan Nahum, Tamir Dagan, Gabriel Chodick, and Oded ScheuermanComments to Author 
Author affiliations: Tel-Aviv University, Tel-Aviv, Israel (A. Lowenthal, H. Weisblum-Neuman, E. Birk, L. Ashkenazi-Hoffnung, I. Levy, H. Ben-Zvi, G. Amir, G. Frenkel, E. Bruckheimer, H. Yarden-Bilavsky, D. Marom, E. Shostak, E. Nahum, T. Dagan, G. Chodick, O. Scheuerman); Schneider Children’s Medical Center of Israel, Petach-Tikva, Israel (A. Lowenthal, H. Weisblum-Neuman, E. Birk, L. Ashkenazi-Hoffnung, I. Levy, G. Amir, G. Frenkel, E. Bruckheimer, H. Yarden-Bilavsky, E. Shostak, E. Nahum, T. Dagan, O. Scheuerman); Rabin Medical Center, Beilinson Hospital, Petach-Tikva (H. Ben-Zvi); Tel Aviv Sourasky Medical Center, Tel Aviv (D. Marom)

Main Article

Table 3

Comparison of the characteristics of case-patients with infective endocarditis by specific causative pathogen, Israel, 1994–2019*

Characteristic Kingella species, n = 19 Streptococcus species, n = 25 Staphylococcus aureus species, n = 16 p value
Age, mo, mean (SD)
 16 (+ 10.29)
 106.3 (+ 70.43)
 68 (+ 75.89)
 <0.001†
Sex
F 6 (32) 15 (60) 10 (62) 0.104
M
 13 (68)
 10 (40)
 6 (38)
Congenital heart disease 10 (52) 21 (84) 11 (69) 0.079
Known murmur 7 (37) 19 (76) 10 (62.5) 0.031‡
Recent surgery 3 (16) 2 (8) 6 (37) 0.055
Recent dental procedure 0 5 (20) 1 (6.2) 0.077
Community-acquired infection 19 (100.0) 23 (92.0) 10 (62.5) 0.003§
Temperature, °C, median (IQR) 40 (39.45–40) 39 (39–39.6) 39 (38.4–40) 0.013†
Fever duration, d, median (IQR) 7 (4.5–14) 7 (2–21) 5 (3–7) 0.514
Hepatosplenomegaly 4 (21) 15 (60) 9 (56) 0.025‡
Oral aphthae 5 (26) 0 0 0.002†
Musculoskeletal infection 2 (11.8) 0 0 0.111
Microhematuria 5 (26.3) 13 (52.0) 10 (62.5) 0.08
Leukocyte count, K/mL, mean (SD) 20.87 (+ 12.39) 12.68 (+ 4.77) 22.18 (+ 12.23) 0.005‡
Neutrophils, K/mL, mean (SD) 12.98 (+ 8.49) 9.34 (+ 4.30) 17.27 (+ 11.41) 0.012§
Lymphocytes, K/mL, mean (SD) 4.27 (+ 3.04) 2.09 (+ 1.36) 2.40 (+ 2.38) 0.007†
NLR, mean (SD) 4.7 (6.7) 7.8 (10.4) 15.2 (11.5) 0.01‡
C-reactive protein, mean (SD) 12.56 (+ 6.79) 10.67 (+ 10.21) 15.23 (+ 11.33) 0.385
Reduced ventricular function 4 (21) 4 (16) 7 (44) 0.12
Central nervous system involvement 4 (21) 5 (21) 3 (19) 0.983
Death 0 3 (12.5) 3 (25) 0.074
Culture positivity as major Duke criteria 7 (37) 24 (96) 16 (100) <0.001†
Echocardiography as major Duke criteria 16 (84) 13 (52) 10 (62) 0.083
Immunologic involvement as minor Duke criteria 0 5 (20) 4 (25) 0.078
Culture as minor Duke criteria 11 (58) 1 (4) 0 <0.001†
Vegetation 10 (53) 6 (24) 8 (50) 0.1

*Values are no. (%) except as indicated. Bold indicates statistical significance (p<.05). IE, infective endocarditis; NLR, neutrophil–lymphocyte ratio.
†Denotes statistical significance between Kingella IE and both Streptococcus IE and Staphylococcus aureus IE.
‡Denotes statistical significance between Kingella IE and Streptococcus IE.
§Denotes statistical significance between Kingella IE and Staphylococcus aureus IE.

Main Article

1These authors contributed equally to this article.

Page created: January 21, 2021
Page updated: February 21, 2021
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