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This past week I was asked to consult on a patient regarding a possible snake envenomation because of severe inflammation of the forearm after working in the garden. The problem was infection, not snakebite. The suspected source was a rose thorn prick.
Rose thorn injury, as it turns out, sometimes can pose a pretty severe health threat. Check out any gardening blog and you are likely to find tales of thorn-caused woe. UK-based websites (http://www.gardenbanter.co.uk) are one example and also have the added benefit of disquieting understatement in the narratives of relevant incidents (“Whilst I was gardening….”). The best-appreciated risk is infection and most well-known type is a fungal disease called Sporotrichosis. The specific fungus that causes this condition is properly known as Sporothrix schenckii, a name that makes it sound like a rare and much-prized fossil dinosaur, rather than a lowly mold with a predilection for rose thorns. Sporotrichosis typically manifests as a slow-growing skin lesion, but it can involve local lymph nodes and spread even more widely in the body. Sporotrichosis has such a strong association with rose thorn injury that this condition is sometimes referred to as “rose picker’s disease.”
As it turns out, however, that is only one infection borne by rose thorns. A number of other fungi can be contracted in this way, too. Even more dangerous is the risk of bacterial infection. One specific bacterial pathogen, Pantoea agglomerans, seems to be linked to rose thorns more than any other (this infectious agent can also be present in medically-acquired infections). Medical publications over the years have documented a number of serious bacterial infections preceded by rose pricks – some of these have even been unlucky cases in which the thorn had punctured a joint, leading to infection there. Moreover, any rose thorn-associated contamination can be more serious in person with a pre-existing condition compromising the body’s ability to fight-off infection. Earlier this year, for example, the BBC aired a cautionary report of a diabetic man who stepped on a rose thorn and eventually lost his leg to infection (http://www.bbc.co.uk/news/health-17278379).
Rose thorns, if left imbedded, can also cause mechanical irritation and there has even been one report of a gardener who lost part of the arterial supply to his hand due to repeated thorn jabs. Gauging by various medical reports, other plant thorns can also be bad actors, in particular date palm and hawthorn thorns. Cause and effect are not always clear-cut, however. Topical plant thorns are implicated in a specific South American fungal condition called Jorge Lobo’s disease, although this infection also occurs among North American dolphins who are clearly not out there gardening.
Amidst all this, it may be somewhat reassuring to note that at least serious allergy to roses is not particularly common, although it has been reported. The most striking (and florid) case I have read is that of Turkish man (Turkey is a big center for commercial rose growing) who suffered an anaphylactic attack from rose pollen after drinking the morning dew collected from their petals. So I guess the take home lesson is that, barring rose pollen allergy, we should stop and smell the roses. But if we are going to handle them, it is advised to wear gloves and never to take lightly an infection or other troubling thorn injury if it occurs. Finally, we can keep our romance with the rose and even with its dew – as Petruchio instructs in Taming of the Shrew – “Say that she frown, I'll say she looks as clear as morning roses newly washed with dew.”
