Chryseobacterium indologenes central nervous system infection in infancy: an emergent pathogen?

Infection. 2014 Feb;42(1):179-83. doi: 10.1007/s15010-013-0479-y. Epub 2013 May 25.

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.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Ceftazidime / therapeutic use
  • Central Nervous System Infections / diagnosis*
  • Central Nervous System Infections / drug therapy
  • Central Nervous System Infections / microbiology*
  • Cerebrospinal Fluid / microbiology
  • Chryseobacterium / isolation & purification*
  • Communicable Diseases, Emerging / diagnosis*
  • Communicable Diseases, Emerging / drug therapy
  • Communicable Diseases, Emerging / microbiology*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Flavobacteriaceae Infections / diagnosis*
  • Flavobacteriaceae Infections / drug therapy
  • Flavobacteriaceae Infections / microbiology*
  • Humans
  • Infant
  • Male
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Ceftazidime