Neonatal meningitis due to Citrobacter koseri.

A five day old neonate was diagnosed as having bacterial meningitis and commenced on Ampicillin and Flucloxacillin. The organism was then found to be Citrobacter koseri and the antibiotics changed to Chloramphenicol systemically for two weeks. The child made an uneventful recovery. At four weeks of age her head circumference had increased unacceptably and a computerised axial tomography scan revealed a large frontal lobe abscess. Aspiration revealed a large pus filled cavity and Citrobacter koseri grown from the pus. The abscess was treated with repeated aspirations, often of 30-40 mls., and installation of Chloramphenicol combined with systemic Chloramphenicol for three weeks. At six months of age her head circumference was within normal limits and the was developmentally normal with no detectable neurological sequelae.