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.
References
Doran TI. The role of Citrobacter in clinical disease of children : review. Clin Infect Dis. 1999;28:384–94.
Samonis G, Karageorgopoulos DE, Kofteridis DP, Matthaiou DK, Sidiropoulou V, Maraki S, Falagas ME. Citrobacter infections in a general hospital : characteristics and outcomes. Eur J Clin Microbiol Infect Dis. 2009;28:61–8.
Chastain MA. A cycle : recurrent Gram-negative folliculitis with Citrobacter diversus (koseri) following eradication of recurrent staphylococcal pyoderma. Arch Dermatol. 2000;136:803.
Garcia-Bustinduy M, Lecuona M, Guimera F, Saez M, Dorta S, Sanchez R, Noda A, Garcia-Montelongo R. Citrobacter koseri in scalp folliculitis. Cutis. 2002;69:393–4.
Bishara J, Gabay B, Samra Z, Hodak E, Pitlik S. Cellulitis caused by Citrobacter diversus in a patient with multiple myeloma. Cutis. 1998;61:158–9.
Kluger N, Cartron G, Bessis D, Guillot B, Girard C. Citrobacter koseri cellulitis during anti-CD20 monoclonal antibody (ofatumumab) treatment for B-cell chronic lymphocytic leukaemia. Acta Derm Venereol. 2010;90:99–100.
Canario DG, Remé P, Cunha BA. Citrobacter koseri infection and abscess associated with Harrington rods. Am J Infect Control. 2004;32:372–4.
Lin SY, Ho MW, Yang YF, Liu JH, Wang IK, Lin SH, Huang CC. Abscess caused by Citrobacter koseri infection: three case reports and a literature review. Intern Med. 2011;50:1333–7.
Lipsky BA, Hook EW 3rd, Smith AA, Plorde JJ. Citrobacter infections in humans: experience at the Seattle Veterans Administration Medical Center and a review of the literature. Rev Infect Dis. 1980;2:746–60.
Altmann G, Sechter I, Braunstein I, Gerichter CB. Citrobacter koseri isolated in Israel, 1972–83. Isr J Med Sci. 1984;20:1056–60.
Drelichman V, Band JD. Bacteremias due to Citrobacter diversus and Citrobacter freundii. Incidence, risk factors, and clinical outcome. Arch Intern Med. 1985;145:1808–10.
Neubert U, Jansen T, Plewig G. Bacteriologic and immunologic aspects of Gram-negative folliculitis : a study of 46 patients. Int J Dermatol. 1999;38:270–4.
Böni R, Nehrhoff B. Treatment of Gram-negative folliculitis in patients with acne. Am J Clin Dermatol. 2003;4:273–6.
Jansen T, Plewig G. Acne fulminans. Int J Dermatol. 1998;37:254–7.
Abdelaziz AA, Ashour, Hefni H, el-Tayeb OM. Microbial contamination of cosmetics and personal care items in Egypt—eye shadows, mascaras and face creams. J Clin Pharm Ther. 1989;14:21–8.
Ashour, Abdelaziz AA, Hefni H, el-Tayeb OM. Microbial contamination of cosmetics and personal care items in Egypt—body lotions and talcum powders. J Clin Pharm Ther. 1989;14:207–12.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Raia, D.D., Barbareschi, M. & Veraldi, S. Citrobacter koseri folliculitis of the face. Infection 43, 595–597 (2015). https://doi.org/10.1007/s15010-015-0734-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-015-0734-5