The neonates become very sick and present sepsis, meningitis, and cerebritis, seizures, apnea, and a bulging fontanelle. No evidence of stiff neck or high-grade fever is present. Complications Occasionally, it causes meningitis, but it can cause sepsis, ventriculitis, and cerebritis with 80% frequent multiple brain abscesses in low-birth-weight, immunocompromised neonates; rare cases have been reported in older children and adults, most of whom have underlying diseases. Arterial and venous infarctions are possible because of the bacterial infiltration along the main vessel; exudates within the ventricles and ventriculitis may obstruct the ventricular foramina and result in a multicystis hydrocephalus with consequent long-lasting shunting difficulties, and necrotizing meningeoencephalitis with pneumocephalus has been reported. Pathogenicity The pathogenic mechanism is poorly understood.<unk>  may have a unique ability to penetrate, survive, and replicate into vascular endothelial cells and macrophages. Furthermore, it survives in phagolysozomal fusion and replicates within macrophages, which may contribute to the establishment of chronic abscesses.
Citrobacter koseri
Escherichia coli
Enterobacter cloacae
Klebsiella oxytoca
Enteroaggregative Escherichia coli
Escherichia coli O121
Escherichia coli O157:H7
Proteus mirabilis