Recurrent meningitis due to Salmonella enteritidis: a case report from Kashmir India

B A Fomda1, B A Charoo, J A Bhat

  • 1Department of Microbiology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, India.

Insights

Recurrent bacterial meningitis in infants, caused by Salmonella enteritidis, can reappear weeks after initial treatment. This case highlights the need for physician awareness regarding potential relapse despite initial antibiotic success.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Recurrent bacterial meningitis poses significant risks to infants, including life-threatening complications and psychological distress from repeated hospitalizations.
  • Salmonella enteritidis is a recognized cause of bacterial meningitis, particularly in neonates and young infants.

Observation:

  • A one-month-old infant presented with recurrent meningitis.
  • Cerebrospinal fluid (CSF) and blood cultures initially identified Salmonella enteritidis.
  • The infant received a 3-week course of intravenous ciprofloxacin and ceftriaxone, showing initial improvement and becoming afebrile.

Findings:

  • Despite apparent successful treatment, the infant was readmitted 28 days post-discharge with fever and refusal to feed.
  • Repeat blood and CSF cultures again confirmed the presence of Salmonella enteritidis, indicating treatment failure or relapse.
  • This recurrence occurred despite a full course of appropriate antibiotics.

Implications:

  • Physicians must be educated about the potential for recurrent bacterial meningitis, even weeks after seemingly effective antibiotic therapy.
  • This case underscores the importance of vigilant follow-up and consideration of relapse in pediatric meningitis patients.
  • Further research into optimal treatment durations and management strategies for recurrent Salmonella meningitis in neonates is warranted.

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