Citrobacter freundii infection in glutaric aciduria type 1: adding insult to injury.
Glutaric aciduria type 1 (GA1) is an inborn error of organic acid metabolism, where the brain is the principal organ affected with exposure to toxic metabolic product, 3-hydroxyglutaric acid (3-OHGA). A 2-year-old boy with GA1 and delayed developmental milestones had an acute neurological crisis leading to massive brain abscess with Citrobacter freundi infection, a rare cause of neonatal meningitis and often associated with brain abscess. Both 3-OHGA and C. freundii can damage the blood-brain barrier and can cause significant trauma which demands immediate and appropriate management. Encephalopathic manifestations of GA1 may consequently increase the risk of meningeal infection and it has not been previously documented.
Mukhopadhyay
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Department of Microbiology, Kasturba Medical College, Manipal, Karnataka, India. chiranjay@yahoo.co.in
Dey
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Bairy
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D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D020739:Brain Diseases, Metabolic, Inborn / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism; D002675:Child, Preschool; D016971:Citrobacter freundii / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D004756:Enterobacteriaceae Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D005977:Glutarates / Q000378:metabolism / Q000652:urine; D006801:Humans; D008297:Male; D054069:Multiple Acyl Coenzyme A Dehydrogenase Deficiency / Q000235:genetics / Q000378:metabolism*
C108959:3-hydroxyglutaric acid; D000900:Anti-Bacterial Agents; D005977:Glutarates