Pantoea agglomerans as a Cause of Foreign Body Related Septic Arthritis in a Child: Case Report and Review of the Literature

Abstract

AbstractA previously healthy 7-year-old female patient was admitted with pain and swelling in her left knee and fever. She had injured her left knee 2 weeks ago. Her mother had noticed a protrusion on her knee that she had thought to be associated with a fracture. After being examined by an orthopaedist, fracture was ruled out and the protrusion disappeared. On her admission with fever and painful swollen knee, Pantoea agglomerans was identified in the synovial fluid. On the basis of the close association of P. agglomerans infections with penetrating trauma, the patient and her mother were asked about a history of penetration during the fall, but they denied any possible penetration of a vegetative element since she had fallen on a concrete floor. Although she was treated with antibiotics reported to be sensitive in the antibiogram, she had recurrent septic arthritis. Repeated magnetic resonance imaging (MRI) interpretations revealed a foreign body in the medial aspect of the left knee. The patient underwent arthrotomy and a plant thorn was removed. The postoperative course was uneventful. We reported this case to emphasize that a vegetative foreign body should be kept in mind in septic arthritis caused by P. agglomerans and/or in those resistant to antibiotics. In addition, we reviewed the literature including children having joint and/or bone infections caused by P. agglomerans.