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Kingella Infections


Larry M. Bush

, MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University;

Maria T. Vazquez-Pertejo

, MD, FACP, Wellington Regional Medical Center

Reviewed/Revised Sep 2022

Kingella are gram-negative organisms that colonize the human oropharynx. They cause skeletal infections, endocarditis, and bacteremia and, rarely, pneumonia, epiglottitis, meningitis, abscesses, and ocular infections.

Kingella, which belong to the family Neisseriaceae, are short, nonmotile, gram-negative coccobacilli that occur in pairs or short chains. The organisms are slow-growing and fastidious. Kingella are recovered from the human oropharynx and are a rare cause of human disease.

Among Kingella species, Kingella kingae is the most frequent human pathogen; these organisms frequently colonize the mucous membranes of the oropharynx. Children aged 6 months to 4 years have the highest rates of colonization and invasive disease from this pathogen. K. kingae is transmitted from child to child through close personal contact (eg, at day care centers). Infection has a seasonal distribution, with more cases in fall and winter.

Diseases Caused by Kingella

The most common manifestations of K. kingae disease are

Rare manifestations include pneumonia, epiglottitis, meningitis, abscesses, and ocular infections.

The most common skeletal infection is septic arthritis, which most frequently affects large, weight-bearing joints, especially the knee and ankle.

Osteomyelitis most frequently involves bones of the lower extremities. Onset is insidious, and diagnosis is often delayed. Hematogenous invasion of intervertebral disks (spondylodiscitis) can occur, most commonly in the lumbar intervertebral spaces.

Kingella endocarditis has been reported in all age groups, but it is rare in adults. Endocarditis may involve native or prosthetic valves. Kingella is a component of the so-called HACEK HACEK Infections The HACEK group (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) includes weakly... read more group (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae), which includes fastidious gram-negative bacteria capable of causing endocarditis.

Diagnosis of Kingella infections requires laboratory isolation from fluids or tissues thought to be infected.

Treatment of Kingella Infections

  • A penicillin or cephalosporin

Kingella organisms are generally susceptible to various penicillins and cephalosporins. However, antimicrobial susceptibility testing is needed to guide therapy. Other useful drugs include aminoglycosides, trimethoprim/sulfamethoxazole, tetracyclines, erythromycin, and fluoroquinolones.

Drugs Mentioned In This Article

Drug Name Select Trade
Primsol, Proloprim, TRIMPEX
A/T/S, Akne-mycin, E.E.S., Emcin Clear , EMGEL, E-Mycin, ERYC, Erycette, Eryderm , Erygel, Erymax, EryPed, Ery-Tab, Erythra Derm , Erythrocin, Erythrocin Lactobionate, Erythrocin Stearate, Ilosone, Ilotycin, My-E, PCE, PCE Dispertab , Romycin, Staticin, T-Stat
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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