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Pyogenic flexor tenosynovitis due to Kingella kingae in an infant
  1. Conor Garry1,2,
  2. Andrew Ernst3,
  3. Matthew Langford2 and
  4. Daniel J Adams2
  1. 1Orthopaedic Surgery, NYU Langone Health, New York, New York, USA
  2. 2Orthopaedic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  3. 3Orthopedic Surgery, US Naval Hospital Camp Pendleton, Camp Pendleton, California, USA
  1. Correspondence to Dr Conor Garry; conor.garry{at}


Pyogenic flexor tenosynovitis is relatively common but is seldom reported in young children. Kingella kingae is increasingly recognised as a causative agent. We report on an infant who presented with a palmar deep space infection and pyogenic flexor tenosynovitis caused by K. kingae. K. kingae is a fastidious, often culture-negative, organism which has been increasingly recognised as a cause of paediatric orthopaedic infections, including flexor tenosynovitis. Clinical suspicion should be heightened, and antibiotic coverage broadened in the setting of a positive physical examination and negative blood cultures.

  • Primary Care
  • Bone and joint infections
  • Orthopaedics
  • Infant health

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  • Contributors CG: drafting, reviewing, literature search, operative technique review and direct publication assistance. AE: drafting, reviewing, literature search, operative technique review and direct publication assistance. ML: operative technique review and reviewing. DJA: research into antibiotic resistance profiles and current therapies and stewardship practices and reviewing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.