RECURRING VENTRICULITIS DUE TO CITROBACTER-DIVERSUS - CLINICAL AND BACTERIOLOGICAL ANALYSIS

Neonatal meningitis due to Citrobacter diversus is usually accompanied by the development of brain abscesses and tends to have high rates of morbidity and mortality. We report a case of a newborn with C diversu s meningitis and brain abscesses who relapsed after initial antibiotic therapy and from whom C. diversus was recovered from cerebrospinal fl uid 4 years later during a neurosurgical procedure. Genetic difference s in the early and late isolates were discovered, and explanations for this phenomenon are suggested. Possible mechanisms for prolonged pers istence in the central nervous system are explored. This unusual case and the analysis of the organisms illustrate the unique features of C diversus as a pathogen and underscore the need for developing optimal therapeutic strategies.