Neonatal citrobacter meningitis: neurosonographic observations.

Meningitis caused by gram-negative enteric bacteria usually is limited in children to the neonatal period. Among neonates, the disease is severe, with a mortality of up to 80%. The most common etiologic agent in this type of meningitis is Escherichia coli. Meningitis due to Citrobacter diversus has occurred in sporadic small outbreaks throughout the United States. This devastating disease frequently results in death, brain abscess, or white matter necrosis.1–3 Central nervous system infection with Citrobacter diversus seems to have a unusual propensity for producing massive white matter necrosis, liquefaction, cavitation, and brain abscess. The morbid anatomy, possible pathophysiologic events, and neurosonographic findings of Citrobacter diversus meningitis are distinct from the findings in meningitis from more common bacterial agents and are described here. CASE REPORT