title: Chryseobacterium indologenes central nervous system infection in infancy: an emergent pathogen?
abstract: The isolation of Chryseobacterium indologenes as a causative micro-organism in human diseases is rare. Risk factors for infections caused by this pathogen include very young and very old age, indwelling devices, immune suppression and recent use of broad-spectrum antibiotics. Most cases suffer from bacteraemia or nosocomial pneumonia, whilst infection of the central nervous system (CNS) is extremely rare. We present a term-born infant diagnosed prenatally with holoprosencephaly and obstructive hydrocephalus, requiring post-natal ventriculoperitoneal shunt insertion. At 6 weeks of age, he suffered from Escherichia coli meningitis, showing satisfactory clinical response with antimicrobial therapy. Aged 11 months, he suffered from hyper-drainage syndrome, resulting in the removal of the shunt system. He represented 11 days post-operatively, with low-grade fever, irritability and cerebrospinal fluid (CSF) leakage. C. indologenes from CSF was isolated and antimicrobial therapy with ceftazidime and trimethoprim-sulfamethoxazole for 3 weeks resulted in good clinical response. This is the first documented community-acquired CNS infection due to C. indologenes in an infant without concomitant indwelling device or previous antibiotic pressure.
authors.affiliation: Department of Paediatric Infectious Diseases and Immunodeficiency, Hospital Infantil Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013, Seville, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Olbrich
authors.forename: M
authors.initials: M
authors.lastname: Rivero-Garvía
authors.forename: M D
authors.initials: MD
authors.lastname: Falcón-Neyra
authors.forename: J A
authors.initials: JA
authors.lastname: Lepe
authors.forename: J M
authors.initials: JM
authors.lastname: Cisneros
authors.forename: J
authors.initials: J
authors.lastname: Marquez-Rivas
authors.forename: O
authors.initials: O
authors.lastname: Neth
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D002494:Central Nervous System Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D045247:Chryseobacterium / Q000302:isolation & purification*; D021821:Communicable Diseases, Emerging / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D045826:Flavobacteriaceae Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002442:Ceftazidime