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Recurring ventriculitis due to Citrobacter diversus: clinical and bacteriologic analysis
Summary
Neonatal meningitis caused by Citrobacter diversus can lead to brain abscesses and poor outcomes. A rare case showed C. diversus meningitis relapsing 4 years later, highlighting pathogen persistence and the need for new treatments.
Area of Science:
- Infectious Diseases
- Neonatal Medicine
- Neuroscience
Background:
- Neonatal meningitis caused by Citrobacter diversus presents significant morbidity and mortality, often associated with brain abscesses.
- Early antibiotic therapy is standard, but treatment failures and relapses can occur, posing challenges in management.
Observation:
- A case report details a newborn diagnosed with Citrobacter diversus meningitis and brain abscesses.
- The infant experienced a relapse of meningitis 4 years after initial antibiotic treatment, with C. diversus isolated from cerebrospinal fluid during a neurosurgical procedure.
Findings:
- Genetic analysis revealed distinct differences between the initial and late C. diversus isolates, suggesting potential strain variation or adaptation.
- The prolonged persistence of C. diversus in the central nervous system was explored, with potential mechanisms discussed.
Implications:
- This unusual case highlights the complex behavior of C. diversus as a neonatal pathogen.
- Findings underscore the necessity for developing optimized therapeutic strategies to combat persistent or relapsing C. diversus meningitis and brain abscesses.