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Accidental Arthrotomy Causing Aseptic Monoarthritis Due to Agave Sap: A Case Report
Sam T Ontiveros1, Alicia B Minns1
1University of California, San Diego, Department of Emergency Medicine, San Diego, California.
Introduction:
Aseptic inflammatory arthritis has been reported from thorns or cactus needles after inadvertent arthrotomy. Agave sap irritants may cause an aseptic inflammatory arthritis mimicking a septic joint.
Case Report:
A 27-year-old male presented with left knee pain and swelling two hours after suffering an accidental stab wound to his left lateral knee by an agave plant spine. Synovial fluid white blood cell count was 92,730 mm3 with 75% neutrophils and no crystals. Surgical washout was remarkable for turbid fluid and no foreign body. Synovial fluid and blood cultures remained without growth. At two-week follow-up, the patient had recovered.
Conclusion:
Penetrating injuries from agave thorns can cause an inflammatory arthritis that mimics septic arthritis.
Insights
Penetrating injuries from agave plant spines can cause aseptic inflammatory arthritis. This condition mimics septic arthritis, but is not caused by infection.
Area of Science:
- Orthopedics
- Rheumatology
- Toxicology
Background:
- Aseptic inflammatory arthritis can occur after penetrating injuries from thorns or needles.
- Agave sap contains irritants that may trigger inflammatory arthritis, resembling a septic joint.
Purpose of the Study:
- To report a case of aseptic inflammatory arthritis caused by an agave plant spine injury.
- To highlight the differential diagnosis between agave-induced arthritis and septic arthritis.
Main Methods:
- A case report of a 27-year-old male with acute knee pain and swelling after an agave spine injury.
- Analysis of synovial fluid (high white blood cell count, predominantly neutrophils) and negative cultures.
- Surgical washout performed due to suspicion of septic arthritis.
Main Results:
- The patient presented with symptoms mimicking septic arthritis.
- Synovial fluid analysis showed significant inflammation but no signs of infection.
- The patient recovered fully after surgical washout and conservative management.
Conclusions:
- Penetrating injuries from agave thorns can induce an inflammatory arthritis.
- This agave-induced arthritis can clinically mimic septic arthritis, necessitating careful diagnosis.
