[A rare case of sepsis from Citrobacter koseri in adults]
DOI:
https://doi.org/10.7175/cmi.v15i1.1501Keywords:
Citrobacter koseri, Septic arthritis, FeverAbstract
We describe the case of a 53-year-old man, recently diagnosed with decompensated type II diabetes mellitus, admitted to our Department for fever, asthenia, and detection of multiple lung abscesses and pulmonary embolism at chest tomography.
His clinical history revealed just a recent orthopedic surgery of osteosynthesis on the left wrist with normal clinical and instrumental post-surgical evolution. Empirical antibiotic therapy with piperacillin/tazobactam and clindamycin was initiated. During hospital stay, swelling and functional impotence in the right knee occurred. They were investigated by arthrocentesis and magnetic resonance, and diagnosed as septic arthritis.
Blood culture performed at admission tested positive for Citrobacter koseri on several samples where meropenem was added according to antibiogram. On the other hand, the cultures of bronchoaspirate, pulmonary fine needle aspiration, and arthrocentesis were negative.
Antibiotic therapy was administered up to two weeks after discharge and radiological and physical features progressively improved.
References
Sharff KA, Richards EP, Townes JM. Clinical management of septic arthritis. Curr Rheumatol Rep 2013; 15: 332; https://doi.org/10.1007/s11926-013-0332-4
Bauer T, Boisrenoult P, Jenny JY. Post-arthroscopy septic arthritis: current data and practical recommendations. Ortop Traumatol Surg Res 2015; 101 (8 Suppl): S347-S350
Drelichman V, Band JD. Bacteremias due to Citrobacter diversus and Citrobacter freundii. Incidence, risk factors and clinical outcome. Arch Intern Med 1985; 145: 1808-10
Doran TI. The role of Citrobacter in clinical disease of children: review. Clin Infect Dis 1999; 28: 384-94; https://doi.org/10.1086/515106
Kwaees TA, Hakim Z, Weerasinghe C, et al. Muscoloskeletal infections associated with Citrobacter koseri. Coll Surg Engl 2016; 98: 446-9; https://doi.org/10.1308/rcsann.2016.0209
Shirtliff ME, Mader JT. Acute septic arthritis. Clin Microbiol Rev 2002; 15: 527-44;
https://doi.org/10.1128/cmr.15.4.527-544.2002
Mathews CJ, Weston VC, Jones A, et al. Bacterial septic arthritis in adults. Lancet 2010; 375: 846-55; https://doi.org/10.1016/S0140-6736(09)61595-6.
Drinka PJ, Gauerke C, Miller J, et al. Apparent transmission of Citrobacter koseri in catheterized residents on a 17-bed nursing home wing. J Am Geriatr Soc 2003; 51: 140-1; https://doi.org/10.1034/j.1601-5215.2002.51031.x
Lipsky BA, Hook EW 3rd, Smith AA, et al. Citrobacter infections in humans: experience at the Seattle Veterans Administration Medical Center and a review of the literature. Rev Infect Dis 1980; 2: 746-60; https://doi.org/10.1093/clinids/2.5.746
Samonis G, Karageorgopoulos DE, Kofteridis DP, et al. Citrobacter infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis 2009; 28: 61-8; https://doi.org/10.1007/s10096-008-0598-z
Vaz Marecos C, Ferreira M, Ferreira MM, et al. Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri. BMJ Case Rep 2012; 2012: bcr1020114941; https://doi.org/10.1136/bcr.10.2011.4941
Jansen RD, Meadow WL, Schwartz IK, et al. “Bacteriological bit”: Citrobacter diversus osteomyelitis in a neonate. Clin Pediatr (Phila) 1981; 20: 791
Rodrigues J, Rocha D, Santos F, et al. Neonatal Citrobacter koseri Meningitis: Report of Four Cases. Case Rep Pediatr 2014; 2014: 195204; https://doi.org/10.1155/2014/195204
Yagci S, Arslan K, Kocak Tufanet Z, et al. Osteomyelitis due to Citrobacter koseri infection in a diabetic patient. J Endocrinol Metab 2011; 1: 146-8
Müllner GF, Keller H. Spondylitis due to Citrobacter diversus. Case report and review of Citrobacter diversus infections. Schweiz Med Wochenschr 1992; 122: 1173-7
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non-Commercial 4.0 Licence that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. The Publication Agreement can be downloaded here, and should be signed by the Authors and sent to the Publisher when the article has been accepted for publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- Authors are permitted to post their work online after publication (the article must link to publisher version, in html format)