Citrobacter Freundii Skin Infection in an Immunocompetent Subject Simulating Varicella: A Treatment-Resistant Case.
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.
Citrobacter infections in immunocompetent subjects are rare
and occur mainly in the urinary and respiratory tracts.1 Of all
Citrobacter species, Citrobacter freundii is the most frequently isolated
group in these patients.2
A mortality rate of 6.8% has beeń reported in patients hospitalized with
Citrobacter infection, but it can increase dramatically to 17.
8-56% with Citrobacter bacteremia.
There is growing public concern about longer hospital stays and higher
antibiotic.
Dermatol Open J. 2023; 8(1): 1-3. doi: 10.17140/DRMTOJ-8-152
