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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Salmonella enterica Serotype Arizonae Meningitis in a Neonate
Wubishet Lakew1, Abayneh Girma, Elizabeth Triche
1Department of Pediatrics and Child Health, University of Gondar, 196 Gondar, Ethiopia.
Abstract:
Typhoidal and nontyphoidal salmonella infections are common causes of gastroenteritis in the community. However, salmonella only rarely causes invasive infections like meningitis. We report a 13-day-old female neonate with signs and symptoms of meningitis whose cerebrospinal fluid (CSF) culture showed Salmonella enterica serotype Arizonae that was sensitive to ceftriaxone. She presented with fever and failure to feed for 2 days. Despite prompt treatment with ampicillin, gentamicin, and ceftriaxone, she developed communicating hydrocephalus, frequent seizures, and coma that progressed to death after 2 weeks of hospitalization. Salmonella enterica serotype Arizonae is a rare cause of human infection known to leading to meningitis symptoms similar to those caused by other salmonella species. This is the first report of it as a cause of meningitis in a child under one month of age. Therefore, it should be included in the differential diagnosis of Gram-negative bacillary meningitis in immunocompromised children, neonates, and those with contacts with reptiles.
Insights
Salmonella enterica serotype Arizonae rarely causes meningitis. This case highlights its potential in neonates, emphasizing its inclusion in the differential diagnosis for Gram-negative bacillary meningitis in infants.
Area of Science:
- Microbiology
- Infectious Diseases
- Neonatal Medicine
Background:
- Salmonella species are common causes of gastroenteritis.
- Invasive Salmonella infections, such as meningitis, are rare.
- Salmonella enterica serotype Arizonae is an uncommon cause of human infection.
Purpose of the Study:
- To report the first case of Salmonella enterica serotype Arizonae meningitis in a neonate.
- To highlight the clinical presentation and outcome of this rare infection.
- To emphasize the importance of considering this pathogen in neonatal meningitis.
Main Methods:
- Case report of a 13-day-old female neonate presenting with meningitis symptoms.
- Cerebrospinal fluid (CSF) culture to identify the causative agent.
- Clinical management and monitoring of treatment response.
Main Results:
- Cerebrospinal fluid (CSF) culture identified Salmonella enterica serotype Arizonae.
- The neonate developed severe complications including hydrocephalus and seizures.
- Despite treatment, the infant succumbed to the infection after two weeks of hospitalization.
Conclusions:
- Salmonella enterica serotype Arizonae is a rare but serious cause of neonatal meningitis.
- This serotype should be considered in the differential diagnosis of Gram-negative bacillary meningitis in neonates, especially those with reptile exposure.
- Early recognition and appropriate antibiotic therapy are crucial, though outcomes can be poor.
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