Citrobacter koseri meningitis: A neurosurgical condition?

Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri

“…The source of infection was not established. Other case reports describe symptomatic Citrobacter infection occurring from day 1 to day 605 7 and both vertical and nosocomial transmission have been described 7. There is one report of Citrobacter infection in twins: twin one was symptomatic and twin two was asymptomatic, but both had Citrobacter isolated from CSF culture 2…”

“…Traditionally, a combination of third generation cephalosporins and aminoglycosides is chosen,3 5–7 although aminoglycoside resistance has been reported 17. In such cases, amikacin is superior to gentamicin 6…”

“…The length of antibiotherapy should be extended in Citrobacter meningitis to at least 21 days7 and 4–6 weeks if abscesses are present 5 7…”

“…Surgical drainage should also be considered when there is no response to antibiotics. In the literature, the neurosurgical approach is associated with a better prognosis, especially when obstruction is present 5. Cerebritis and infarctation have no surgical indication 5.…”

Citrobacter freundiicausing pharyngitis and secondary retropharyngeal abscess with intrathoracic extension to the diaphragm: minimally invasive management of a rare case

“…However, meningitis, soft tissue infections and abscesses have also been described, all as relatively uncommon occurrences. 3,[5][6][7][8] Only three cases of oropharyngeal infection secondary to citrobacter have been reported: an isolated retropharyngeal abscess without extension in a diabetic patient (C freundii); acute tonsillitis complicated by retropharyngeal and thyroid abscess (C mutans); and peritonsillar and retropharyngeal abscess, mediastinitis and myonecrosis of the strap muscles (polymicrobial, including C diversus). [9][10][11] To our knowledge, there has been no previous report of C freundii causing primary pharyngitis with secondary retropharyngeal and intrathoracic abscesses extending to the diaphragm and involving the thoracic aorta and oesophagus.…”