Case Report of Citrobacter koseri Sepsis in a Newborn That Resulted in Brain Death

Abstract

In this report, we describe the case of a newborn with a rare neonatal infection caused by Citrobacter koseri, which followed a fulminant course. Unfortunately, despite prompt initiation of the sepsis treatment protocol by the health care team, the newborn developed significant complications that affected the central nervous system. As a result, palliative care was instituted, and brain death was declared on the 12th day of life, 6 days after the onset of the first symptoms of the infection. We discuss the epidemiology of C. koseri infection; the therapeutic management of sepsis, including the role of the nurse; and the ethical considerations involved in clinical decision-making. We present this case to encourage reflection on strategies to detect subtle signs of infection and respond early in a critical effort to prevent severe complications.