CSF interleukin-6 in Neonatal Citrobacter ventriculitis after meningitis

An infant with neonatal severe Citrobacter koseri (formerly Citrobacter div ersus) meningoencephalitis developed necrosis with multicystic regression o f both hemispheres. The ventriculitis persisted over months in spite of ant ibiotic therapy. The treatment succeeded with cefotaxime in a high dose (30 0 mg/kg/day) without surgical intervention. The infant had been previously treated with cefotaxime (200 mg/kg/day) over 5 weeks. High levels of CSF in terleukin-6 (IL-6) permitted to attribute persisting CSF pleocytosis in spi te of sterile CSF cultures to chronic infection and not to reminiscence of brain necrosis, This report reveals two main points. On the one hand, the i mportance of therapy monitoring with IL-6 in CSF for the consequent treatme nt of Citrobacter meningitis and on the other hand, high-dose cefotaxime (3 00 mg/ kg/day) treatment of Citrobacter ventriculitis, which succeeded with out surgical intervention.