• cervical osteo-arthritis
• kingella kingae
• polymerase chain reaction
• epstein barr virus
• magnetic resonance imaging

A healthy 2-year-old child was referred to the paediatric emergency department for febrile torticollis with 1 cm painful cervical lymph nodes. Blood tests showed 20.8 mg/L C reactive protein and an acute Epstein-Barr virus infection. The persistence of torticollis despite a regular intake of both paracetamol and ibuprofen for 2 weeks suggested another aetiology. A CT scan associated with MRI showed an inflammatory process at the C1–C2 vertebrae (figure 1), and Kingella kingae-specific PCR was positive on biopsy. Cefamandole (150 mg/kg/day) was given intravenously for 7 days, followed by oral amoxicillin …