Diagnosis and Treatment of Central Nervous System Infection Caused by Chryseobacterium indologenes After Surgery for Intracerebral Hemorrhage

Chryseobacterium indologene s ( C. indologene s) is a rare nonfermenting gram-negative bacillus that can lead to various opportunistic infections. However, postoperative central nervous system (CNS) infections in neurosurgical patients are uncommon. The authors report a case of CNS infection caused by C. indologenes following surgery for intracerebral hemorrhage. On postoperative day 7, the patient developed a high fever, altered consciousness, positive meningeal signs, and vomiting. Cerebrospinal fluid (CSF) analysis suggested a bacterial CNS infection. Empiric treatment with vancomycin and meropenem initially showed limited efficacy. C. indologenes was isolated from 2 consecutive CSF cultures, and antimicrobial susceptibility testing revealed sensitivity to trimethoprim-sulfamethoxazole (TMP-SMX) and ciprofloxacin. Following the adjustment of the treatment regimen, the patient's temperature and CSF parameters gradually improved, and he was discharged in better condition. In this report, the authors retrospectively review the clinical features, diagnostic process, and treatment strategy, while also discussing the resistance profile of C. indologenes based on the relevant literature, aiming to provide valuable insights for clinical practice.