CASE REPORT

Pantoea agglomerans as a cause of septic arthritis after palm tree thorn injury; case report and literature review

A Kratz¹, D Greenberg², Y Barki³, E Cohen⁴, M Lifshitz¹

¹ Pediatrics Department D, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
² Pediatric Infectious Disease Unit, Soroka University Medical Center
³ Department of Radiology, the Ultrasound Unit, Soroka University Medical Center
⁴ Department of Orthopedic Surgery, Soroka University Medical Center

Correspondence to:
Correspondence to:
Dr M Lifshitz, Pediatrics Department D, Soroka University Medical Center, PO Box 151, Beer-Sheba 84101, Israel;
matyl{at}bgumail.bgu.ac.il

We report the case of a 14 year old healthy boy, who was admitted six weeks after being injured by a palm tree thorn, with limping caused by pain and swelling in his right knee. An ultrasound examination revealed a foreign body in the posterior lateral aspect of the right knee. Pantoea agglomerans was identified in the synovial fluid. The patient underwent two arthrotomies and was treated with amoxicillin-clavulanate intravenously for three weeks. The postoperative course was uneventful, and joint function returned to normal.

A review of the literature between 1953 and 2002 revealed that bacterial growth after plant thorn injuries is reported infrequently. Yet when reported, Pantoea agglomearns is the most common organism found. Therefore, it must be considered and suspected in "aseptic" cases of arthritis, when there is a history of a plant thorn injury. We also emphasise the efficacy of ultrasound examination in these cases to identify the presence and location of a plant thorn.

Keywords: Pantoea agglomerans; septic arthritis; plant; thorn

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This article has been cited by other articles:

• Deletoile, A., Decre, D., Courant, S., Passet, V., Audo, J., Grimont, P., Arlet, G., Brisse, S. (2009). Phylogeny and Identification of Pantoea Species and Typing of Pantoea agglomerans Strains by Multilocus Gene Sequencing. J. Clin. Microbiol. 47: 300-310 [Abstract] [Full Text]  
• Cruz, A. T., Cazacu, A. C., Allen, C. H. (2007). Pantoea agglomerans, a Plant Pathogen Causing Human Disease. J. Clin. Microbiol. 45: 1989-1992 [Abstract] [Full Text]  
• (2003). Robin Goodfellow. Rheumatology (Oxford) 42: 1131-1131 [Full Text]  

eLetters:

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This palm tree does not usually cause thorn injury

Nirupa A D'Souza

ADC Online, 23 Jun 2003 [Full text]

Re: This palm tree does not usually cause thorn injury

Assaf Kratz

ADC Online, 9 Jul 2003 [Full text]

Pantoea agglomerans septic arthritis following lemon tree thorn injury

Rolando Ulloa-Gutierrez, et al.

ADC Online, 3 Sep 2003 [Full text]