Citrobacter ventriculitis in a neonate responsive to trimethoprim-sulfamethoxazole.
There are increasing reports of citrobacter central nervous system infections in neonates. These organisms cause brain abcesses in a high percentage of patients. They may be resistant to commonly used antibiotics. We report a term male infant with underlying meningo-myelocoele and hydrocephalus in whom Citrobacter diversus meningitis and ventriculitis developed. Initial antibiotic therapy including intraventricular amikacin failed to sterilize the ventricles or alter a deteriorating clinical course. Adding intravenous trimethoprim-sulfamethoxazole to the therapeutic regimen resulted in reversal of a progressively worsening condition and eventual recovery. Trimethoprim-sulfamethoxazole should be considered as a potentially useful alternative antibiotic for susceptible central nervous system infections.
D000583:Amikacin / Q000627:therapeutic use; D002552:Cerebral Ventricles / Q000382:microbiology*; D002954:Citrobacter / Q000302:isolation & purification; D004338:Drug Combinations / Q000627:therapeutic use; D004660:Encephalitis / Q000150:complications / Q000188:drug therapy*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy*; D008297:Male; D008581:Meningitis / Q000150:complications / Q000188:drug therapy*; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000583:Amikacin; D014295:Trimethoprim; D013420:Sulfamethoxazole