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Curtobacterium species are recognized plant pathogens. We report the first well-documented case of Curtobacterium human infection, a child with septic arthritis following puncture with a Coxspur Hawthorn plant thorn. The organism isolated from synovial tissue and the plant thorn was identified as Curtobacterium flaccumfaciens by 16S rRNA gene sequence analysis. CASE REPORTA previously healthy 7-year-old boy presented with right knee pain 1 day after being pushed into a thorny bush at school. He had noticed swelling and redness at the site of the puncture and was unable to bear weight on his right leg. His symptoms settled somewhat with analgesia and immobilization, and he was discharged the following day. He returned 2 days later with increasing right knee pain, swelling, and fever. He was discharged the next day without antibiotic therapy.Five days later (10 days after the injury), he presented again with a limp and ongoing fevers of up to 39°C. On examination, there was reduced range of right knee flexion, knee swelling without erythema, and a joint effusion. There was a healing puncture wound on the lateral aspect, and palpation of the surrounding area did not suggest the presence of a foreign body. The peripheral blood leukocyte count was 13.1 ϫ 10 9 cells/liter (77% neutrophils). He underwent an arthroscopic washout and synovial biopsy of the right knee. A 1-cm-long piece of thorn was identified in the synovial tissue and removed. Histological examination was consistent with acute synovitis and septic arthritis.Perioperative intravenous (i.v.) cefazolin was administered for 24 h and then changed to i.v. ticarcillin-clavulanate for 8 days. He remained afebrile from the second day of admission and was discharged to continue oral amoxicillin (80 mg/kg body weight/ day) for a further 4 weeks. The residual knee swelling and stiffness resolved slowly with physical therapies over the weeks after discharge. At the 6-month follow-up, he had made a full recovery, with no limitation of movement in the affected knee.Microbiology. The Gram stain of the synovial fluid and knee tissue revealed numerous polymorphonuclear leukocytes but no bacteria. In aerobic conditions at 35°C, bacterial growth was observed on horse blood agar at 24 h. The organism grew equally well and with identical morphology at both 30°C and 37°C. The colonies were nonhemolytic, smooth, entire, low convex, with a yellow pigment. Colonies were 1 to 1.5 mm in diameter after 48 h incubation. Gram stain showed Gram-positive small, short rods, some in palisade arrangements, with no branching. The isolate was nonmotile, catalase positive, and urease negative and strongly hydrolyzed esculin. The API Coryne version 3.0 identification system (bioMérieux, Marcy l'Etoile, France) gave an identification of Brevibacterium species, with a confidence value of 79% (code 2040005). MICs determined using Etest (bioMérieux, Marcy l'Etoile, France) were 0.125 g/ml for penicillin and 0.25 g/ml for cefotaxime and vancomycin.Because of the inconclusive phenotypic identificat...

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Background: Podiatric physicians routinely use electric drills for the treatment of nail and skin conditions. The grinding process produces human nail and skin dust that is generally vacuumed into bags in the grinding unit. Many of the nails are thought to be mycotic, particularly because they are obtained from patients with symptoms of dermatophyte infections. Currently, there is limited information available on the detection of fungi from nail dust samples. Herein, we attempt to address this situation and outline some of the difficulties that pathology laboratories face in isolating and identifying dermatophytes from nail samples. Methods: Fifty nail dust bags from podiatric medical clinics across all of the states and territories of Australia were collected and analyzed. Samples from the bags were inoculated onto primary isolation media. Fungal colonies that grew were then inoculated onto potato dextrose agar for identification using standard morphological (macroscopic and microscopic) features. Results: One hundred fifty-one colonies of dermatophytes were identified from 43 of the 50 samples. In addition 471 nondermatophyte molds were isolated, along with some yeasts and bacteria. Conclusions: The most common dermatophytes isolated were from the Trichophyton mentagrophytes/interdigitale complexes. Trichophyton rubrum, Trichophyton tonsurans, Trichophyton soudanense, and Epidermophyton floccosum were also isolated. An unidentified group of dermatophytes was also present. The three most common genera of nondermatophyte molds were Aspergillus, Penicillium, and Scopulariopsis, all of which have been implicated in onychomycosis and more general disease. The presence of viable fungal pathogens in the dust could potentially pose a health problem to podiatric physicians.