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Salmonella paratyphi A enteric fever mimicking viral meningitis

Deepa Kudalkar1, Marjorie Thermidor, Burke A Cunha

  • 1Infectious Disease Division, Department of Medicine, Winthrop-University Hospital, Mineola, NY 11501, USA.

Heart & Lung : the Journal of Critical Care
|December 15, 2004
PubMed

Insights

Salmonella paratyphi A can cause aseptic meningitis, a rare complication of enteric fever. This case highlights the importance of considering enteric fever in febrile patients returning from endemic areas.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • Enteric fevers are systemic infections caused by invasive Salmonella species.
  • Salmonella typhi causes classic enteric fever, while Salmonella paratyphi A, B, or C typically cause less severe forms.
  • Aseptic meningitis is a serious central nervous system complication that can arise from various infections.

Observation:

  • A case of Salmonella paratyphi A enteric fever presented with aseptic meningitis.
  • Prominent headache necessitated a lumbar puncture to rule out meningitis.
  • Classic signs like rose spots were absent in this patient.
  • Common laboratory findings such as elevated serum transaminases and leukopenia were not observed.

Findings:

  • The patient experienced aseptic meningitis secondary to Salmonella paratyphi A infection.
  • The atypical presentation, including the absence of common clinical and laboratory markers, may be attributed to prior antimicrobial therapy.
  • Relative bradycardia was also noted, potentially influenced by pre-admission treatment.

Implications:

  • This case underscores the need to consider Salmonella paratyphi A as a cause of aseptic meningitis.
  • Clinicians should maintain a high index of suspicion for enteric fever in individuals with recent travel history to endemic regions presenting with acute, non-specific febrile illnesses.
  • Prompt diagnosis and appropriate treatment are crucial for managing enteric fever and its complications, even in atypical presentations.

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