title: A rare case of lethal retroperitoneal abscess caused by Citrobacter koseri.
abstract: Retroperitoneal abscesses are very uncommon clinical conditions. The characteristically vague symptomatology of retroperitoneal abscess and the inherent difficulty of identifying retroperitoneal disease by physical examination contributed to these dismal therapeutic outcomes. We present an unusual case of lethal retroperitoneal abscess, caused by Citrobacter diversus(koseri), treated with surgical drainage. Citrobacter species have rarely been involved in deep tissue infection and there is no reported case of lethal retroperitoneal abscess caused by C. koseri. This case is the only reported case of C. koseri as the sole pathogen associated with a lethal retroperitoneal abscess in immunocompetent patient. The case is also notable because it confirms the recent bacterial resistance to beta-lactam antibiotics and to other antimicrobial agents, like chloramphenicol or cotrimoxazol.
authors.affiliation: Department of Urology, University of Florence, Florence, Italy. ktommy@libero.it
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giubilei
authors.forename: Francesca
authors.initials: F
authors.lastname: Vichi
authors.forename: Umberto
authors.initials: U
authors.lastname: Farina
authors.forename: Antonio
authors.initials: A
authors.lastname: Costanzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000628:therapy; D000368:Aged; D041041:Citrobacter koseri / Q000187:drug effects / Q000302:isolation & purification*; D003131:Combined Modality Therapy; D018450:Disease Progression; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000628:therapy; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D035583:Rare Diseases; D012187:Retroperitoneal Space; D012720:Severity of Illness Index