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Web End = Infection (2015) 43:595597
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Web End = Citrobacter koseri folliculitis of the face
D. D. Raia M. Barbareschi S. Veraldi
Abstract We report a case of severe Citrobacter koseri folliculitis of the face in a boy with acne. A 15-year-old boy affected by acne was admitted because of a rash located on the face. Dermatological examination revealed two large plaques, with numerous pustules, eschars and crusts, located bilaterally and symmetrically on the cheeks. Three bacteriological examinations were positive for C. koseri. The patient was successfully treated with i.m. ceftriaxone. C. koseri is a Gram-negative, aerobic, mobile, nonsporulating bacillus belonging to the Enterobacteriaceae family. It can cause meningitis, central nervous system abscess and sepsis, almost exclusively in infants and immunocompromised hosts. Respiratory tract and urinary infections have been reported in elderly people. Furthermore, rare cases of skin infections have been described.
Keywords Acne Citrobacter koseri Folliculitis Acne fulminans
Introduction
Citrobacter koseri (formerly Levinea malonatica, Citrobacter intermedius and Citrobacter diversus) is a Gram-negative, aerobic, mobile, nonsporulating bacillus belonging to the Enterobacteriaceae family. It rarely causes infections and almost exclusively only in infants and immunocompromised hosts. In particular, it can cause meningitis, central nervous
Received: 20 November 2014 / Accepted: 19 January 2015 / Published online: 29 January 2015 Springer-Verlag Berlin Heidelberg 2015
system (CNS) abscess and sepsis in infants. Most of the cases are sporadic, with no clear source of infection; some cases are vertically transmitted from mother to child. However, outbreaks occur in neonatal care units. The pathogenesis of C. koseri infection is not completely known: a surface protein was identied as a possible virulence factor in strains that cause brain abscess in infants. Despite improvement in diagnostic imaging techniques, antibiotic therapy and surgery, approximately one-third of infants with CNS abscess die [1].Respiratory tract and urinary infections have been reported in the elderly people [2]. Furthermore, rare cases of skin infections caused by C. koseri have been described [38].
We present a case of severe C. koseri folliculitis of the face in a boy with acne.
Case presentation
A 15-year-old...