Citrobacter freundii infection after acute necrotizing pancreatitis in a patient with a pancreatic pseudocyst: a case

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Antonio Lozano-Leon1, Jose Iglesias-Canle, Julio Iglesias-Garcia

  • 1Department of Gastroenterology and Foundation for Research in Digestive Diseases, University Hospital Santiago de Compostela, Spain, A Choupana s/n, 15706, Santiago de Compostela, Spain. antoniolozan@gmail.com.

Journal of Medical Case Reports
|February 9, 2011
PubMed
Abstract

Insights

This case report details the first-ever endoscopic ultrasound-guided diagnosis of Citrobacter freundii in a pancreatic pseudocyst. This finding is crucial for understanding enteric-derived infections in acute necrotizing pancreatitis.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Pancreatic infections are severe complications of acute necrotizing pancreatitis, often with high mortality.
  • The enteric origin of pancreatic infections is suggested but remains controversial.
  • Citrobacter freundii is a potential pathogen in such infections.

Purpose of the Study:

  • To report the first case of isolated Citrobacter freundii in a pancreatic pseudocyst diagnosed via endoscopic ultrasound-guided fine needle aspiration.
  • To highlight the importance of on-site cytology in guiding diagnosis and treatment.

Main Methods:

  • Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) was performed on an 80-year-old male patient with a pancreatic pseudocyst.
  • On-site cytology interpretation of the FNA sample.
  • Microbiologic cultures of the aspirated fluid.

Main Results:

  • Citrobacter freundii was successfully isolated from the pancreatic pseudocyst.
  • On-site cytology provided crucial, immediate feedback for sample analysis.
  • The diagnosis led to appropriate cultures and curative therapy.

Conclusions:

  • Citrobacter freundii can be recovered from pancreatic pseudocysts.
  • EUS-guided FNA with on-site cytology is effective for diagnosing pancreatic infections.
  • This case represents the first reported instance of isolated pancreatic C. freundii diagnosed by EUS-FNA.

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