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Neonatal meningitis and multiple brain abscesses due to Citrobacter diversus
1Division of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada.
Summary
A rare case of neonatal meningitis caused by Citrobacter diversus led to rapid death. Autopsy revealed widespread brain and spinal cord abscesses, with infection likely originating from the umbilical cord (septic omphalitis).
Area of Science:
- Neonatal infectious diseases
- Neuropathology
- Microbiology
Background:
- Neonatal meningitis is a serious infection requiring prompt diagnosis and treatment.
- Citrobacter diversus is an opportunistic pathogen that can cause severe neonatal infections.
Observation:
- A sporadic case of neonatal meningitis caused by Citrobacter diversus presented with rapid clinical deterioration.
- The infant developed purulent meningitis complicated by multiple brain and spinal cord abscesses.
Findings:
- Septic omphalitis (umbilical cord infection) was identified as the most probable portal of entry for the pathogen.
- The autopsy findings confirmed extensive central nervous system involvement.
Implications:
- This case highlights the aggressive nature of Citrobacter diversus meningitis in neonates.
- Early recognition of omphalitis as a potential source of neonatal sepsis is crucial for prevention and timely intervention.