Kingella kingae intrauterine infection: An unusual cause of chorioamnionitis and miscarriage in a patient with undifferentiated connective tissue disease

Maria Paola Bonasoni, Andrea Palicelli, Giulia Dalla Dea, Giuseppina Comitini, Giulia Pazzola, Giuseppe Russello, Graziella Bertoldi, Marcellino Bardaro, Claudia Zuelli, Edoardo Carretto

Research output: Contribution to journalArticlepeer-review

Abstract

Kingella kingae is a Gram-negative coccobacillus belonging to the Neisseriaceae family. In children less than 4 years old, K. kingae invasive infection can induce septic arthritis and osteomyelitis, and more rarely endocarditis, meningitis, ocular infections, and pneumonia. In adults, it may be a cause of endocarditis. To date, K. kingae acute chorioamnionitis (AC) leading to preterm rupture of membranes (PPROM) and miscarriage has never been reported. Herein, we describe a case of intrauterine fetal death (IUFD) at 22 weeks’ gestation due to K. kingae infection occurred in a patient affected by undifferentiated connective tissue disease (UCTD) in lupus erythematosus systemic (LES) evolution with severe neutropenia. K. kingae was isolated in placental subamnionic swab and tissue cultures as well as fetal ear, nose, and pharyngeal swabs. Placental histological examination showed necrotizing AC and funisitis. In the fetus, neutrophils were observed within the alveoli and in the gastrointestinal lumen. Maternal medical treatment for UCTD was modified according to the K. kingae invasive infection. In the event of IUFD due to AC, microbiological cultures on placenta and fetal tissues should always be carried out in order to isolate the etiologic agent and target the correct medical treatment.

Original languageEnglish
Article number243
JournalDiagnostics
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Chorioamnionitis undifferenti-ated connective tissue disease
  • Kingella kingae
  • Preterm premature rupture of membrane

ASJC Scopus subject areas

  • Clinical Biochemistry

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