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Joseph Junewick, MD FACR
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Citrobacter Meningoencephalitis

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 4 years ago
Updated: over 4 years ago
Tags: Pets
Modality/Study Types: US MR
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5 week old with fever, leukocytosis and “full” fontanelle

Case Images


Citrobacter meningoencephalitis


US – Coronal high resolution anterior image reveals echogenic intraventricular CSF. Sagittal and coronal images show circumscribed left frontal abscess with fluid/debris level.

MR – Axial post-gadolinium T2 FLAIR and diffusion/ADC

Clinical – CSF and abscess specimens


Citrobacter is a facultative anaerobic gram negative bacillus found in the intestinal tract and an exceedingly rare form of meningoencephalitis. Vertical transmission during the birth process is suspected but the source of infection cannot be identified in most cases. Citrobacter is the most common etiology for a brain abscess in a neonate; brain abscesses occur in 75% of patients with Citrobacter meningitis. Significant short-term and long-term neurological complications can be expected.


Meier A, Chusid MJ, Sty JR. Neonatal Citrobacter Meningitis: Neurosonographic Observations. J Ultrasound Med (1998); 17:399–401.


Jordan Whatley, MD

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