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Citrobacter freundii causing pharyngitis and secondary retropharyngeal abscess with intrathoracic extension to the diaphragm: minimally invasive management of a rare case

Published online by Cambridge University Press:  23 March 2010

A Trinidade ,
V Sekhawat ,
Z Andreou ,
J Meldrum ,
S Kamat  and
J Panesar
A Trinidade*
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
V Sekhawat
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
Z Andreou
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
J Meldrum
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
S Kamat
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
J Panesar
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
*
Address for correspondence: Mr Aaron Trinidade, ENT Department, Luton and Dunstable Hospital, Lewsey Road, Luton LU4 0DZ, UK. E-mail: [email protected]
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Abstract

Introduction:

Citrobacter freundii is a rare but potentially aggressive cause of pharyngitis which may progress to retropharyngeal abscess with diaphragmatic extension.

Objective:

To raise awareness of: (1) citrobacter as a potential cause of head and neck infection, including retropharyngeal abscess; (2) a novel surgical approach to draining such an abscess; and (3) citrobacter's particular biological properties which may affect the clinical course.

Method:

Case report.

Results:

The abscess was drained via a minimally invasive posterior pharyngeal wall incision and placement of a suction catheter into the mediastinum through this incision. Residual intrathoracic collections were drained by the cardiothoracic team via percutaneous aspiration. The patient made a full recovery.

Conclusion:

Early recognition of citrobacter head and neck infections, an awareness of the peculiarities of the clinical course of such infections, and timely surgical intervention can prevent catastrophic outcomes. A minimally invasive approach to mediastinal collections can be considered as a viable alternative to open thoracotomy, which carries a high morbidity rate.

Keywords

Citrobacter FreundiiRetropharyngeal Abscess
Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , e4
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Mohanty, S, Singhal, R, Sood, S, Dhawan, B, Kapil, A, Das, BK. Citrobacter infections in a tertiary care hospital in Northern India. J Infect 2007;54:58–64CrossRefGoogle Scholar
2Lipsky, 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;2:746–60CrossRefGoogle Scholar
3Samonis, G, Karageorgopoulos, DE, Kofteridis, DP, Matthaiou, DK, Sidiropoulou, V, Maraki, S et al. Citrobacter infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis 2009;28:61–8CrossRefGoogle Scholar
4Canario, DG, Remé, P, Cunha, BA. Citrobacter koseri infection and abscess associated with Harrington rods. Am J Infect Control 2004;32:372–4CrossRefGoogle ScholarPubMed
5Martínez-Lage, JF, Martínez-Lage Azorín, L, Almagro, MJ, Bastida, ME, Reyes, S, Tellez, C. Citrobacter koseri meningitis: a neurosurgical condition? Eur J Paediatr Neurol 2009; Aug 28. [Epub ahead of print]Google ScholarPubMed
6Cai, T, Giubilei, G, Vichi, F, Farina, U, Costanzi, A, Bartoletti, R. A rare case of lethal retroperitoneal abscess caused by Citrobacter koseri. Urol Int 2007;79:364–6CrossRefGoogle ScholarPubMed
7Yalçi, A, Pişkin, N, Aydemir, H, Gürbüz, Y, Türkyilmaz, FR. A case with psoas abscess caused by Citrobacter freundii. Turk J Gastroenterol 2006;17:248–9Google ScholarPubMed
8Tomita, H, Osada, S, Miya, K, Matsuo, M. Delayed recurrence of postoperative intra-abdominal abscess: an unusual case and review of the literature. Surg Infect (Larchmt) 2006;7:551–4CrossRefGoogle ScholarPubMed
9Aderdour, L, Hassani, R, Nejmi, H, Elfakiri, MM, Maliki, O, Droussi, H et al. Retropharyngeal abscess revealing diabetes: a case report. Ann Endocrinol (Paris) 2008;69:526–9CrossRefGoogle ScholarPubMed
10Maini, S, Brown, MJ, Ali, O, Davies, S, Al Shafi, KM. Acute tonsillitis complicated by retropharyngeal and thyroid abscess infected with de-repressed beta lactamase Citrobacter mutans. J Laryngol Otol 2001;115:327–9CrossRefGoogle ScholarPubMed
11Civen, R, Väisänen, ML, Finegold, SM. Peritonsillar abscess, retropharyngeal abscess, mediastinitis, and nonclostridial anaerobic myonecrosis: a case report. Clin Infect Dis 1993;16(Suppl. 4):S299–303CrossRefGoogle ScholarPubMed
12Ridder, GJ, Technau-Ihling, K, Sander, A, Boedeker, CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg 2005;133:709–14CrossRefGoogle ScholarPubMed
13Mora, R, Jankowska, B, Catrambone, U, Passali, GC, Mora, F, Leoncini, G et al. Descending necrotizing mediastinitis: ten years' experience. Ear Nose Throat J 2004;83:774, 776–80CrossRefGoogle ScholarPubMed
14Rizvi, M, Fatima, N, Rashid, M, Shukla, I, Malik, A, Usman, A et al. Extended spectrum AmpC and metallo-beta-lactamases in Serratia and Citrobacter spp. in a disc approximation assay. J Infect Dev Ctries 2009;3:285–94CrossRefGoogle Scholar
15Minarini, LA, Poirel, L, Cattoir, V, Darini, AL, Nordmann, P. Plasmid-mediated quinolone resistance determinants among enterobacterial isolates from outpatients in Brazil. J Antimicrob Chemother 2008;62:474–8CrossRefGoogle ScholarPubMed
16al-Ibrahim, KE. Descending necrotising mediastinitis: a case report and review of the literature. Eur J Cardiothoracic Surg 1995;9:161–2CrossRefGoogle Scholar
17Wheatley, MJ, Stirling, MC, Kirsh, MM, Gago, O, Orringer, MB. Descending necrotizing mediastinitis: transcervical drainage is not enough. Ann Thorac Surg 1990;49:780–4CrossRefGoogle ScholarPubMed
18Estrera, AS, Landay, MJ, Grisham, JM, Sinn, DP, Platt, MR. Descending necrotizing mediastinitis. Surg Gynecol Obstet 1983;157:545–52Google ScholarPubMed
19Adelson, RT, Murray, AD. Minimally invasive transoral catheter-assisted drainage of a danger-space infection. Ear Nose Throat J 2005;84:785–6CrossRefGoogle ScholarPubMed