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Sepsis, meningitis and cerebral abscesses caused by Citrobacter koseri

dc.contributor.authorMarecos, C
dc.contributor.authorFerreira, M
dc.contributor.authorFerreira, MM
dc.contributor.authorBarroso, R
dc.date.accessioned2014-02-13T17:16:08Z
dc.date.available2014-02-13T17:16:08Z
dc.date.issued2012
dc.description.abstractAfter a 36-week diamniotic dichorionic gestation, an infant was delivered by elective caesarean section due to growth restriction and altered diastolic flow in the umbilical artery. Birth weight was 2140 g. The patient was admitted for exclusive parenteral nutrition, with umbilical venous catheter placement. Sinus tachycardia and temperature instability with positive inflammatory markers occurred at 51 h. Penicillin and gentamicin were started, but 6 h later septic shock with disseminated intravascular coagulation was noted. Vancomycin and meropenem were started and penicillin suspended. Citrobacter koseri was isolated from blood culture. Generalised clonic convulsions occurred on day 4, and an electroencephalogram revealed severe encephalic dysfunction. Cerebrospinal fluid cytochemical analysis was suggestive of meningitis, although culture was negative. Cefotaxime was added to the drug regimen. Cranioencephalic MR showed a temporal abscess and diffuse hemispheric destruction, with no indications for neurosurgery. After 6 weeks of therapy, neuroimaging follow-up showed multiloculated cystic encephalomalacia. Currently, the patient is 14 months old with axial hypotonia and decreased movements. The source of infection has not been determined. Nosocomial infection cannot be excluded and vertical transmission is unlikely.por
dc.identifier.citationBMJ Case Rep. 2012 Jan 23por
dc.identifier.issn1757-790X
dc.identifier.urihttp://hdl.handle.net/10400.10/1066
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherBMJ Pub. Grouppor
dc.relation.publisherversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279664/pdf/bcr.10.2011.4941.pdfpor
dc.subjectBrain abscesspor
dc.subjectAbcesso cerebralpor
dc.subjectSepsispor
dc.subjectCross infectionpor
dc.subjectInfecção cruzadapor
dc.subjectChildpor
dc.titleSepsis, meningitis and cerebral abscesses caused by Citrobacter koseripor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceLondonpor
oaire.citation.titleBMJ Case Reportspor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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