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Abstract:
Three cases of salmonella meningitis in infants were successfully treated with a combination of intraventricular and systemic antibiotics after standard treatment had failed. The intraventricular antibiotics were administered through a subcutaneously implanted ventriculostomy reservoir. The ventricular fluid cultures were positive in all cases. The organisms in the ventricle may periodically reinoculate the subarachnoid space and add to the difficulty in curing salmonella meningitis. Details of the prolonged treatment (29-59 days) and the antibiotic levels obtained are presented. No local reservoir complications were encountered. All three patients were developing normally 10 to 18 months following treatment including two who required a shunt procedure for nonabsorptive hydrocephalus.
Insights
This study shows that combining intraventricular and systemic antibiotics successfully treated Salmonella meningitis in infants when standard methods failed. Prolonged treatment via a reservoir led to normal development in all patients.
Area of Science:
- Pediatric Infectious Diseases
- Neuroscience
- Microbiology
Background:
- Salmonella meningitis in infants is a serious infection.
- Standard antibiotic treatments can be challenging to cure.
- Intraventricular antibiotic delivery may overcome treatment resistance.
Purpose of the Study:
- To report successful treatment of infant Salmonella meningitis.
- To evaluate the efficacy of combined intraventricular and systemic antibiotics.
- To describe the long-term outcomes of this treatment approach.
Main Methods:
- Three infants with refractory Salmonella meningitis were treated.
- Intraventricular antibiotics were administered via a ventriculostomy reservoir.
- Treatment duration was prolonged (29-59 days) with systemic antibiotics.
Main Results:
- All three infants achieved successful treatment outcomes.
- Ventricular fluid cultures remained positive initially, indicating persistent infection.
- No complications related to the intraventricular reservoir were observed.
Conclusions:
- Combined intraventricular and systemic antibiotics offer a viable treatment for resistant Salmonella meningitis in infants.
- Intraventricular delivery may be crucial for eradicating persistent organisms.
- Long-term neurodevelopmental outcomes were favorable, even with shunt procedures.