Citrobacter is a genus of gram-negative bacteria in the family of the Enterobacteriaceae. (coliform)
The species C. amalonaticus, C. koseri, and C. freundii use solely citrate as a carbon source. These bacteria can be
found almost everywhere in soil, water, wastewater, etc. It can also be found in the human intestine. They are rarely the
source of illnesses, except for infections of the urinary tract and infant meningitis.
http://encyclopedia.thefreedictionary.com/CITROBACTER
Citrobacter: C. freundii is suspected to cause diarrhea and possibly extraintestinal infections. C. diversus has been
linked to a few cases of meningitis in newborns.
Pediatr Crit Care Med. 2004 Jul;5(4):393-5. Links
Pneumocephalus in neonatal meningitis: diffuse, necrotizing meningo-encephalitis in Citrobacter meningitis presenting
with pneumatosis oculi and pneumocephalus.Pooboni SK, Mathur SK, Dux A, Hewertson J, Nichani S.
Paediatric Critical Care Unit, Glenfield Hospital, Leicester, UK.
OBJECTIVE/PATIENT: Gas-containing encephalitis is rarely associated with neonatal meningitis. We report a case of a
19-day-old baby who presented with a rapid onset of septic shock complicated by progressively increasing gas
accumulation within the brain and anterior chamber of the eye. We describe the evolution of the clinical picture and the
management. INTERVENTIONS: Ventilatory support, fluid resuscitation, and continuous venovenous hemofiltration were
provided in view of multiple system failure. Despite effective antibiotic therapy and supportive management, the patient
died with worsening accumulation of gas within the brain, resulting in brainstem death. RESULTS: Computed
tomographic images were characteristic of diffuse necrotizing meningo-encephalitis. Postmortem examination showed
friable brain tissue with venous infarction and extensive gas accumulation. Citrobacter koseri was identified from the
blood and cerebrospinal fluid cultures. CONCLUSION: This case re-emphasises the importance of C. koseri as both a
community-acquired and nosocomial neonatal pathogen. Radiologic evidence suggestive of diffuse necrotizing
meningo-encephalitis in combination with pneumocephalus and pneumatosis oculi in Citrobacter infections has never
been described before. Diagnostic imaging with computed tomographic scanning of the brain and initiation of
broad-spectrum antibiotics with good penetration into cerebrospinal fluid are indicated as soon as infection with
Citrobacter species is suspected clinically, with appearance of pneumatosis oculi as a rare, late finding.
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=15215013&dopt=AbstractPlus