Diagnosis

We had our consult with the Infectious Disease team. I would say that they are 95% sure of the diagnosis -- Septic Arthritis caused by a bacteria called Kingella Kingae. Kingella is a normal bacteria that is found in the throats of preschool-aged children. If something disrupts the mucosal lining of the throat, like an upper respiratory infection,the Kingella can cross the epithelium by using the RTX toxin to break through the tissue. Then it enters the bloodstream which allows it to reach deeper tissues like bones and joints where it seeds itself and multiplies. It most often affects the hip or knee joint which receive a large blood supply during these years of fast growth. Kingella is slow-growing festering kind of bacteria, unlike the more familiar strep and staph bacteria which cause fast and furious infection. The 35,000 white blood cell count also supports this diagnosis. The head of the Infectious Disease team said that he saw what appeared to be a small amount of bone irritation on the x-rays that were taken. Only a bacterial infection, not a viral one could cause this. To know for sure whether there is a bone infection, we must wait for one of two things: the bone biopsy to come back and/or a followup x-ray in 2 weeks and another in 4 weeks. If there is a bone infection, the x-ray will show that as time passes. As the bone heals, it would show bony changes on an x-ray. We found out a couple of interesting things. Cerebral Palsy has nothing to do with this infection. It was just a random, rare, and unfortunate occurrence. In fact, her doctor, the senior orthopedic specialist at Duke, has never treated another individual with CP who had this infection. Aliyah will not be more susceptible to this type of infection in the future, and there should be no negative long-term effects since we caught it so early. We are so thankful that it is an infection and not an autoimmune disorder; we can get this cleared up and leave this experience behind us. We know it has an end.