Citrobacter brain abscesses in neonates: early surgical intervention and review of the literature

Abstract

Citrobacter koseri, a facultatively anaerobic, lactose-fermenting, gram-negative bacilli, has a strong propensity to form cerebral abscesses. C. koseri brain abscesses can be a devastating disease of infancy and childhood with more than 30% succumbing to the disease and more than 50% suffering severe neurological deficits. This study represents a retrospective review of two cases of C. koseri brain abscesses along with a review of the literature regarding diagnosis and treatment. Early aggressive surgical and medical treatment resulted in favorable outcomes for two children with C. koseri brain abscesses, one diagnosed at 6 weeks of age and the other at 2 months of age. C. koseri brain abscesses can be devastating and have been associated historically with significant morbidity and mortality. However, favorable outcomes are possible, and aggressive surgical and medical management should be considered for patients with C. koseri abscesses.