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Salmonella enteritidis ventriculitis
A J Johan1, L C Hung, O Norlijah
1Department of Pediatric, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor. johan@medic.upm.edu.my
The Southeast Asian Journal of Tropical Medicine and Public Health
|September 21, 2013
Summary
Salmonella meningitis in Malaysian infants can relapse, even after prolonged antibiotic treatment. This case highlights challenges in treating ventriculitis and determining optimal antibiotic duration for Salmonella enteritidis infections.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Neurology
- Microbiology
Background:
- Salmonella species are a significant cause of meningitis in neonates and young children, particularly in Malaysia.
- Bacterial meningitis in infants requires prompt and effective antimicrobial therapy.
Observation:
- A six-week-old female infant presented with Salmonella enteritidis meningitis, initially treated unsuccessfully with a third-generation cephalosporin.
- The patient experienced a relapse of meningitis, complicated by ventriculitis and hydrocephalus, necessitating an extended eleven-week course of meropenem.
Findings:
- Clinical improvement was observed with meropenem, but cerebrospinal fluid (CSF) glucose levels remained persistently low.
- The lack of CSF glucose normalization despite prolonged meropenem treatment indicates potential challenges in eradicating Salmonella enteritidis ventriculitis.
Implications:
- This case underscores the diagnostic and therapeutic dilemmas in managing recurrent Salmonella meningitis and ventriculitis in neonates.
- Determining the optimal duration of antibiotic therapy for Salmonella enteritidis ventriculitis remains a clinical challenge, potentially impacting long-term neurological outcomes.
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