Pantoea agglomerans as a cause of septic arthritis after palm tree thorn injury; case report and literature review
- 1Pediatrics Department D, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- 2Pediatric Infectious Disease Unit, Soroka University Medical Center
- 3Department of Radiology, the Ultrasound Unit, Soroka University Medical Center
- 4Department of Orthopedic Surgery, Soroka University Medical Center
- 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
- Accepted 12 November 2002
Abstract
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.
