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Adult Citrobacter freundii meningitis: case report.
Y C Chuang1, W N Chang, C H Lu
1Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi
|March 1, 2000
Summary
Multi-antibiotic resistant Citrobacter freundii caused a rare adult meningitis and subdural empyema post-neurosurgery. Standard antibiotics failed, highlighting a significant therapeutic challenge for this life-threatening infection.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Neuroscience
Background:
- Citrobacter are Gram-negative bacilli in the Enterobacteriaceae family.
- Central nervous system (CNS) infections from Citrobacter are rare, particularly in adults.
- Adult Citrobacter meningitis is exceptionally uncommon, with few cases reported historically.
Observation:
- This case involves an adult with post-neurosurgical meningitis and subdural empyema.
- The infection was caused by multi-antibiotic resistant Citrobacter freundii.
- Initial antimicrobial therapy with imipenem and third-generation cephalosporins was ineffective in sterilizing cerebrospinal fluid.
Findings:
- The patient developed a nosocomial CNS infection with multi-drug resistant Citrobacter.
- Broad-spectrum antibiotic use contributed to the development of antibiotic resistance.
- This resistant strain presented a significant therapeutic challenge.
Implications:
- This case underscores the growing threat of multi-antibiotic resistant organisms in healthcare settings.
- Effective treatment strategies for resistant Citrobacter CNS infections are urgently needed.
- Further clinical research is essential to establish updated therapeutic guidelines for these severe infections.