Related Experiment Video
Updated: May 21, 2026

Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
Published on: June 15, 2019
Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri
Clara Vaz Marecos1, Marta Ferreira, Maria Manuela Ferreira
1Paediatric Department, Professor Doutor Fernando Fonseca Hospital, EPE, Lisbon, Portugal. claravazmarecos@gmail.com
Abstract:
After a 36-week diamniotic dichorionic gestation, an infant was delivered by elective caesarean section due to growth restriction and altered diastolic flow in the umbilical artery. Birth weight was 2140 g. The patient was admitted for exclusive parenteral nutrition, with umbilical venous catheter placement. Sinus tachycardia and temperature instability with positive inflammatory markers occurred at 51 h. Penicillin and gentamicin were started, but 6 h later septic shock with disseminated intravascular coagulation was noted. Vancomycin and meropenem were started and penicillin suspended. Citrobacter koseri was isolated from blood culture. Generalised clonic convulsions occurred on day 4, and an electroencephalogram revealed severe encephalic dysfunction. Cerebrospinal fluid cytochemical analysis was suggestive of meningitis, although culture was negative. Cefotaxime was added to the drug regimen. Cranioencephalic MR showed a temporal abscess and diffuse hemispheric destruction, with no indications for neurosurgery. After 6 weeks of therapy, neuroimaging follow-up showed multiloculated cystic encephalomalacia. Currently, the patient is 14 months old with axial hypotonia and decreased movements. The source of infection has not been determined. Nosocomial infection cannot be excluded and vertical transmission is unlikely.
Related Concept Videos
Brain Abscess l: Introduction
Bacterial Meningitis I: Introduction
Bacterial Meningitis II: Pathophysiology
Viral Meningitis
Staphylococcal Skin Infections
Reservoir of Infection
