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*Citrobacter* Meningitis
Surjith Vattoth, MD, FRCR; Gary L. Hedlund, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Citrobacter cerebritis
              • Definitions

                • Gram-negative enteric bacterium infection

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Chen D et al: New insights into Citrobacter freundii sepsis in neonates. Pediatr Int. 61(4):375-80, 2019
                                          2. Lechowicz M et al: Multiple brain abscesses caused by Citrobacter koseri in a preterm neonate - case Report. Pol J Radiol. 82:837-41, 2017
                                          3. Nuñez Cuadros E et al: Medical and neurosurgical management of Citrobacter koseri, a rare cause of neonatal meningitis. J Med Microbiol. 63(Pt 1):144-7, 2014
                                          4. Plakkal N et al: Citrobacter freundii brain abscess in a preterm infant: a case report and literature review. Pediatr Neonatol. 54(2):137-40, 2013
                                          5. Vaz Marecos C et al: Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri. BMJ Case Rep. 2012, 2012
                                          6. Martínez-Lage JF et al: Citrobacter koseri meningitis: a neurosurgical condition? Eur J Paediatr Neurol. 14(4):360-3, 2010
                                          7. Samonis G et al: Citrobacter infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis. 28(1):61-8, 2009
                                          8. Benca J et al: Nosocomial meningitis caused by Enterobacteriaceae: risk factors and outcome in 18 cases in 1992-2007. Neuro Endocrinol Lett. 28 Suppl 2:27-9, 2007
                                          9. Alviedo JN et al: Diffuse pneumocephalus in neonatal Citrobacter meningitis. Pediatrics. 118(5):e1576-9, 2006
                                          10. Agrawal D et al: Vertically acquired neonatal citrobacter brain abscess - case report and review of the literature. J Clin Neurosci. 12(2):188-90, 2005
                                          11. Pooboni SK et al: Pneumocephalus in neonatal meningitis: diffuse, necrotizing meningo-encephalitis in Citrobacter meningitis presenting with pneumatosis oculi and pneumocephalus. Pediatr Crit Care Med. 5(4):393-5, 2004
                                          12. Prais D et al: Citrobacter koseri (diversus) meningitis in an otherwise healthy adolescent. Scand J Infect Dis. 35(3):202-4, 2003
                                          13. Badger JL et al: Citrobacter freundii invades and replicates in human brain microvascular endothelial cells. Infect Immun. 67(8):4208-15, 1999
                                          14. Doran TI: The role of Citrobacter in clinical disease of children: review. Clin Infect Dis. 28(2):384-94, 1999
                                          15. Meier A et al: Neonatal citrobacter meningitis: neurosonographic observations. J Ultrasound Med. 17(6):399-401, 1998
                                          16. Tse G et al: Neonatal meningitis and multiple brain abscesses due to Citrobacter diversus. Pediatr Pathol Lab Med. 17(6):977-82, 1997
                                          17. Kline MW et al: Citrobacter diversus and neonatal brain abscess. Pediatr Neurol. 3(3):178-80, 1987
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Citrobacter cerebritis
                                                      • Definitions

                                                        • Gram-negative enteric bacterium infection

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Chen D et al: New insights into Citrobacter freundii sepsis in neonates. Pediatr Int. 61(4):375-80, 2019
                                                                                  2. Lechowicz M et al: Multiple brain abscesses caused by Citrobacter koseri in a preterm neonate - case Report. Pol J Radiol. 82:837-41, 2017
                                                                                  3. Nuñez Cuadros E et al: Medical and neurosurgical management of Citrobacter koseri, a rare cause of neonatal meningitis. J Med Microbiol. 63(Pt 1):144-7, 2014
                                                                                  4. Plakkal N et al: Citrobacter freundii brain abscess in a preterm infant: a case report and literature review. Pediatr Neonatol. 54(2):137-40, 2013
                                                                                  5. Vaz Marecos C et al: Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri. BMJ Case Rep. 2012, 2012
                                                                                  6. Martínez-Lage JF et al: Citrobacter koseri meningitis: a neurosurgical condition? Eur J Paediatr Neurol. 14(4):360-3, 2010
                                                                                  7. Samonis G et al: Citrobacter infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis. 28(1):61-8, 2009
                                                                                  8. Benca J et al: Nosocomial meningitis caused by Enterobacteriaceae: risk factors and outcome in 18 cases in 1992-2007. Neuro Endocrinol Lett. 28 Suppl 2:27-9, 2007
                                                                                  9. Alviedo JN et al: Diffuse pneumocephalus in neonatal Citrobacter meningitis. Pediatrics. 118(5):e1576-9, 2006
                                                                                  10. Agrawal D et al: Vertically acquired neonatal citrobacter brain abscess - case report and review of the literature. J Clin Neurosci. 12(2):188-90, 2005
                                                                                  11. Pooboni SK et al: Pneumocephalus in neonatal meningitis: diffuse, necrotizing meningo-encephalitis in Citrobacter meningitis presenting with pneumatosis oculi and pneumocephalus. Pediatr Crit Care Med. 5(4):393-5, 2004
                                                                                  12. Prais D et al: Citrobacter koseri (diversus) meningitis in an otherwise healthy adolescent. Scand J Infect Dis. 35(3):202-4, 2003
                                                                                  13. Badger JL et al: Citrobacter freundii invades and replicates in human brain microvascular endothelial cells. Infect Immun. 67(8):4208-15, 1999
                                                                                  14. Doran TI: The role of Citrobacter in clinical disease of children: review. Clin Infect Dis. 28(2):384-94, 1999
                                                                                  15. Meier A et al: Neonatal citrobacter meningitis: neurosonographic observations. J Ultrasound Med. 17(6):399-401, 1998
                                                                                  16. Tse G et al: Neonatal meningitis and multiple brain abscesses due to Citrobacter diversus. Pediatr Pathol Lab Med. 17(6):977-82, 1997
                                                                                  17. Kline MW et al: Citrobacter diversus and neonatal brain abscess. Pediatr Neurol. 3(3):178-80, 1987