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Citrobacter koseri meningitis: a neurosurgical condition?
Juan F Martínez-Lage1, Laura Martínez-Lage Azorín, María José Almagro
1Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, 30120 El Palmar, Murcia, Spain. juanf.martinezlage@cablemurcia.com
Summary
A rare Citrobacter koseri brain infection in an infant was successfully treated with antibiotics, surgery, and urokinase. This approach prevented severe complications like hydrocephalus, offering a promising treatment strategy.
Area of Science:
- Neonatal Neurology
- Infectious Diseases
- Pediatric Neurosurgery
Background:
- Citrobacter koseri is a Gram-negative bacterium with a high predilection for causing brain infections in neonates.
- C. koseri infections can lead to severe complications including meningitis, ventriculitis, and brain abscesses, with significant neurological sequelae and mortality rates.
Observation:
- A 2-month-old infant presented with meningitis, ventriculitis, and brain abscess due to C. koseri infection.
- The infant developed loculated hydrocephalus and ventricular complications.
Findings:
- Successful treatment was achieved using a combination of antibiotics, intra-cavitary urokinase, and surgical intervention.
- This multimodal approach effectively managed the brain abscess and prevented the progression of hydrocephalus and ventricular loculation.
Implications:
- This case highlights the critical role of neurosurgical management in addressing severe C. koseri brain infections in infants.
- The use of intra-cavitary urokinase demonstrates potential in preventing or treating loculated hydrocephalus, a common complication.
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