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Pantoea agglomerans foreign body-induced septic arthritis

Omer Rave1, Marc Victor Assous, Philip J Hashkes

  • 1Pediatric Department, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel.

The Pediatric Infectious Disease Journal
|August 29, 2012
PubMed

Insights

A thorn caused Pantoea septic arthritis in a child. Prompt diagnosis and removal of the foreign body are crucial for effective treatment of this rare condition.

Area of Science:

  • Pediatric Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Septic arthritis is a joint infection that can lead to rapid joint destruction.
  • Pantoea agglomerans is an uncommon cause of septic arthritis, particularly in children.
  • Foreign body-induced arthritis can mimic other joint pathologies.

Purpose of the Study:

  • To report a case of pediatric septic arthritis caused by Pantoea agglomerans secondary to a retained foreign body.
  • To emphasize the importance of considering foreign bodies in the differential diagnosis of septic arthritis.
  • To highlight the diagnostic utility of imaging and microbiological techniques.

Main Methods:

  • Case presentation of a 4-year-old boy with acute knee arthritis.
  • Synovial fluid analysis including Gram stain, culture, and 16S rDNA polymerase chain reaction (PCR) for bacterial identification.
  • Diagnostic ultrasound to identify intra-articular abnormalities.
  • Arthroscopic surgical intervention for foreign body removal and joint lavage.

Main Results:

  • Synovial fluid culture and 16S rDNA PCR confirmed Pantoea agglomerans infection.
  • Ultrasound revealed a thorn within the knee joint.
  • Arthroscopic removal of the thorn and subsequent joint irrigation were performed.
  • The patient's arthritis resolved following surgical intervention and appropriate treatment.

Conclusions:

  • Pantoea agglomerans can cause septic arthritis, and retained foreign bodies are a potential predisposing factor.
  • A high index of suspicion and thorough investigation, including imaging, are necessary to identify foreign bodies in suspected septic arthritis.
  • Early diagnosis and management, including foreign body removal, are essential for favorable outcomes in pediatric septic arthritis.

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