ro13-9904 and Folliculitis

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.

Topics: Adolescent; Anti-Bacterial Agents; Ceftriaxone; Citrobacter koseri; Enterobacteriaceae Infections; Face; Folliculitis; Humans; Male; Treatment Outcome

Sinus thrombosis is an acute life-threatening disease. While cavernous sinus thrombosis secondary to facial infections is described in the literature, it is uncommon. The key clinical characteristics are a facial infection, headache, chemosis and edema of the eyelid. The main differential diagnostic consideration is meningoencephalitis. Early diagnosis by angiography, magnetic resonance imaging and examination of CSF is important as treatment should be initiated as soon as possible in order to decrease morbidity and mortality. The mainstays of therapy are heparinization and appropriate intravenous antibiotic therapy.

Topics: Adult; Angiography; Anti-Bacterial Agents; Anticoagulants; Cavernous Sinus Thrombosis; Ceftriaxone; Diagnosis, Differential; Folliculitis; Follow-Up Studies; Humans; Male; Phenprocoumon; Prognosis; Skin; Staphylococcal Infections; Staphylococcus aureus; Time Factors; Tomography, X-Ray Computed