ABSTRACT

Brain abscesses related to Citrobacter freundii are rarely encountered during adulthood. Usually, central nervous system (CNS) infections linked with this agent are reported in infancy and childhood. Although rare, there are reported cases of CNS infections with C. freundii under the predisposition of various factors such as multiple facial fractures, previous history of neurosurgical interventions, chronic alcoholism, and diabetes mellitus. A 55-year-old woman with a history of breast tumor was admitted to our clinic with the diagnosis of metastatic brain tumor. Other possible factors causing intracranial masses were not considered in the differential diagnosis due to her previous medical history. The patient was operated on under the supposition that she had a metastatic brain tumor; however, intraoperative findings of the lesion were similar to those of an abscess. Microbiological evaluation of the resected specimen revealed an intracranial abscess with a positive culture for C. freundii. This case highlights the wide spectrum of intracranial abscesses in immune compromised patients and necessitates a high index of suspicion for appropriate management. Many rare pathogens can be encountered in chronically ill individuals.