Citrobacter Freundii Skin Infection in an Immunocompetent Subject Simulating Varicella: A Treatment-Resistant Case
DOI:
https://doi.org/10.17140/DRMTOJ-8-152Keywords:
Citrobacter freundii, Skin infection, Immunocompetent subject, MaliAbstract
Citrobacter spp infections in immunocompetent subjects are rare and mainly involve the urinary and respiratory tracts. We report a
case of Citrobacter freundii skin infection in an immunocompetent patient simulating varicella and having resisted empirical treatment
of common bacterial skin infections on 3 occasions. The patient was 26-years-old and worked in a mining area in Kayes,
Mali. He had no previous medical or surgical history and consulted for diffuse papulopustules on the integument, simulating
chickenpox, for which he had received empirical treatments of common bacterial skin infections without success. In view of
the persistence and appearance of new lesions, he consulted us on 2nd November 2021, where a bacteriology showed Citrobacter
freundii. The patient was treated with ceftazidime and gentamycin with success (according to the patient). Citrobacter spp are facultative
anaerobic Gram-negative bacilli of the Enterobacteriaceae family, frequently found in water, soil, food and the intestines
of animals and humans. They are known to cause a wide spectrum of infections affecting the urinary tract, liver, biliary tract,
peritoneum, intestines, bone, respiratory tract, endocardium, wounds, soft tissue, meninges and bloodstream in immunocompromised
subjects. Our case is atypical in its presentation, immunocompetent subject, clinical form simulating chickenpox without
extracutaneous involvement and which raised the resistance of opportunistic germs to antibiotics.
References
Ferranti M, Cicogna GT, Sattin A, Alaibac M. Citrobacter freun-dii sepsis in an immunosuppressed patient with pemphigus vul-Case Report | Volume 8 | Number 1 | Dermatol Open J. 2023-2024; 8(1): 1-3. doi: 10.17140/DRMTOJ-8-152 garis. BMJ Case Rep. 2018; 11(1): e227091. doi: 10.1136/bcr-2018- 227091
Whalen JG, Mully TW, English JC. Spontaneous Citrobacter freundii infection in an immunocompetent patient. Arch Dermatol. 2007; 143: 124-125. doi: 10.1001/archderm.143.1.124
Liu L-H, Wang N-Y, Wu AY-J, Lin C-C, Lee C-M, Liu C-P. Citro-bacter freundii bacteremia: Risk factors of mortality and preva-lence of resistance genes. J Microbiol Immunol Infect. 2018; 51: 565- 572. doi: 10.1016/j.jmii.2016.08.016
Chlossberg D, Ricci JA, Fugate JS. Dermatologic manifestations of citrobacter septicemia. J Am Acad Dermatol. 1981; 5: 613-615. doi: 10.1016/s0190-9622(81)80042-4
Lipsky BA, Hook EW III, Smith AA, Plorde JJ. Citrobacter in-Submit your article to this journal | https://openventio.org/submit-manuscript/ Case Report | Volume 8 | Number 1 | Moussa S, et al fections in hu- mans: Experience at the Seattle Veterans Adminis-tration Medical Center and a review of the literature. Rev Infect Dis. 1980; 2: 746-760. doi: 10.1093/clinids/2.5.746
Meini S, Tascini C, Cei M, Sozio E, Rossolini GM. AmpC β-lactamase-producing Enterobacterales: What a clinician should know. Infection. 2019; 47(3): 363-375. doi: 10.1007/s15010-019- 01291-9
Lavigne JP, Defez C, Bouziges N, Mahamat A, Sotto A. Clini-cal and molecular epidemiology of multidrug-resistant Citrobacter spp. infections in a French university hospital. Eur J Clin Microbiol Infect Dis. 2007; 26(6): 439-441. doi: 10.1007/s10096-007-0315-3
Chen C, Chen Y, Wu P, Chen B. Update on new medicinal appli-cations of gentamicin: Evidence-based review. J Formos Med Assoc. 2014; 113: 72-82. doi: 10.1016/j.jfma.2013.10.002
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Dermatology (DER) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
