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Published on: July 29, 2022
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.
Abstract:
Recurrent bacterial meningitis in children is potentially life-threatening and induces psychological trauma to the patients through repeated hospitalization. Here we report a case of recurrent meningitis in a one month old baby. The CSF and blood culture grew Salmonella enteritidis. Injection ciprofloxacin and ceftriaxone were given for 3 weeks. Baby became symptomatically better and was afebrile at discharge. Twenty eight days after discharge baby got readmitted with complaints of fever and refusal of feeds. Blood and CSF culture again showed growth of Salmonella enteritidis. Physicians should be educated about the possibility of recurrence which may occur days or even weeks after apparent successful antibiotic treatment.
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