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Open Access Highly Accessed Case report

Citrobacter freundii infection after acute necrotizing pancreatitis in a patient with a pancreatic pseudocyst: a case report

Antonio Lozano-Leon*, Jose Iglesias-Canle, Julio Iglesias-Garcia, Jose Larino-Noia and Enrique Dominguez-Muñoz

Author Affiliations

Department of Gastroenterology and Foundation for Research in Digestive Diseases, University Hospital Santiago de Compostela, Spain, A Choupana s/n, 15706. Santiago de Compostela, Spain

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Journal of Medical Case Reports 2011, 5:51  doi:10.1186/1752-1947-5-51

Published: 7 February 2011

Abstract

Introduction

Infections are the most frequent and severe complications of acute necrotizing pancreatitis with a mortality rate of up to 80 percent. Although experimental and clinical studies suggest that the microbiologic source of pancreatic infection could be enteric, information in this regard is controversial.

Case presentation

We describe a Citrobacter freundii isolation by endoscopy ultrasound fine needle aspiration in a 80-year-old Caucasian man with pancreatic pseudocyst after acute necrotizing pancreatitis.

Conclusion

Our case report confirms that this organism can be recovered in patients with a pancreatic pseudocyst. On-site cytology feedback was crucial to the successful outcome of this case as immediate interpretation of the fine needle aspiration sample directed the appropriate cultures and, ultimately, the curative therapy. To the best of our knowledge, this is the first reported case of isolated pancreatic C. freundii diagnosed by endoscopy ultrasound fine needle aspiration.