Successful Treatment of Neonatal Citrobacter Freundii Meningitis with Ceftriaxone

Abstract

Citrobacter meningitis is an uncommon enteric gram-negative infection that afflicts neonates and young children. Approximately 30 percent of children treated or untreated die from the infection. We report a case of C. freundii meningitis that was resistant to ampicillin and was successfully treated with ceftriaxone, a third-generation cephalosporin. A 13-day-old, full-term baby was admitted to the hospital with a one-day history of fever up to 38.8 degrees C. On admission the infant had a temperature of 39.2 degrees C, pulse of 140 beats/min, and a respiratory rate of 32 breaths/min. Except for a slightly bulging fontanelle, the rest of the physical examination was within normal limits. Complete blood count revealed a white blood cell (WBC) count of 12.5 x 10(9)/L, with 0.66 polymorphonuclear cells, 0.10 bands, 0.18 lymphocytes, and 0.06 monocytes. A stat lumbar puncture showed 10 WBCs per high-power field with gram-negative rods. Empiric therapy with ampicillin 225 mg q12h and gentamicin 11 mg q8h was started. Both antibiotics were discontinued after culture and sensitivity results were positive for C. freundii in the blood and spinal fluid. The patient was successfully treated with nine days of ceftriaxone 250 mg q12h.

Unusual microtubule-dependent endocytosis mechanisms triggered by Campylobacter jejuni and Citrobacter freundii.

“…Although Citrobacter freundii is often considered an enterobacterial commensal of the human intestinal flora, it has been associated with diarrhea in children (12) and has been reported to cause invasive infections such as neonatal meningitis with a high mortality (13), isolated cases of'pyomyo-…”

Identification of infant food as a vehicle in a nosocomial outbreak of Citrobacter freundii: epidemiological subtyping by allozyme, whole‐cell protein and antibiotic resistance

“…In particular, Citrobacters have been isolated as the causative agent of infections of the urinary tract, wounds and the respiratory tract. There have been rare isolations from cases of septicaemia and meningitis and occasionally from hospital infection outbreaks (Ullmann 1986;Ramani et al 1988;Flegg et al 1989;Christo et al 1990;Rae et al 1991).…”