Presumed Kingella kingae Septic Arthritis in an 18-Month-Old Child: The First Suspected Case Reported From Georgia

Kingella (K.) kingae is an important cause of osteoarticular infections (OAIs) in young children, particularly between 6 and 36 months of age.However, these infections can be difficult to recognize because affected children often have mild systemic symptoms, only moderate elevations in inflammatory markers, and negative conventional cultures.Diagnosis is especially challenging in settings where K. kingae-specific molecular testing is not available.We describe an 18-month-old girl who developed refusal to bear weight and pain on movement of the left hip following a recent febrile respiratory illness.Despite remaining relatively well clinically, she had persistent limitation of hip movement, elevated inflammatory markers, progressive thrombocytosis, and a hip joint effusion on ultrasonography.These findings raised concern for septic arthritis.Intravenous ceftriaxone was started, followed by rapid resolution of fever and gradual improvement in mobility.Serial ultrasonography showed reduction of the joint effusion, and the child subsequently regained independent walking.Blood cultures remained negative.Joint aspiration was not performed because the effusion was small and the child was already showing clear clinical and laboratory improvement.As K. kingae-specific polymerase chain reaction (PCR) testing was not available locally, microbiological confirmation could not be obtained, and the diagnosis remained presumptive.To the best of our knowledge, this is the first suspected case of K. kingae septic arthritis reported from Georgia.The case highlights an important diagnostic challenge: septic arthritis caused by K. kingae may present with relatively mild systemic findings and can easily be mistaken for transient synovitis or remain classified as a culture-negative infection.Greater awareness of this pathogen and wider availability of molecular testing could improve diagnosis, allow more targeted antimicrobial treatment, and help clarify the currently unknown burden of K. kingae OAIs in Georgia.