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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Intracranial infection and sepsis in infants caused by Salmonella derby: A case report
Jing-Lu Yu1, Li-Li Jiang1, Rong Dong2
1Department of Clinical Laboratory, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
Insights
Salmonella derby, a common gut bacterium, rarely causes intracranial infections in infants. This case highlights a rare instance of Salmonella derby meningitis in an infant, emphasizing the need for timely diagnosis and treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Salmonella derby is a Gram-negative bacterium typically found in the digestive tract, causing gastroenteritis.
- While common, S. derby infections are rarely severe, though they can lead to conditions like conjunctivitis, pneumonia, and endocarditis.
- Intracranial infections caused by S. derby in infants are exceptionally rare and previously unreported in China.
Observation:
- A 4-month-old infant presented with persistent fever and a convulsive episode, indicating a serious underlying condition.
- Cerebrospinal fluid analysis revealed Gram-negative bacilli identified as Salmonella derby.
- Initial treatments for infectious fever were ineffective, necessitating specialized care.
Findings:
- This case represents the first reported instance of Salmonella derby causing meningitis in an infant in China.
- The bacterium likely crossed the blood-brain barrier to infect the cerebrospinal fluid, leading to purulent meningitis.
- Prompt antibiotic treatment with meropenem and ceftriaxone was crucial for the infant's recovery.
Implications:
- This case underscores the potential for Salmonella derby to cause severe, life-threatening central nervous system infections in infants.
- Early detection and appropriate antibiotic therapy are critical for managing S. derby meningitis.
- Further research may be needed to understand the pathogenesis and risk factors for invasive S. derby infections in neonates.
Background:
Salmonella derby (S. derby) is a Gram-negative diplococcus that is common in the digestive tract. Infected patients generally experience symptoms such as fever and diarrhea. Mild cases are mostly self-healing gastroenteritis, and severe cases can cause fatal typhoid fever. Clinical cases are more common in children. The most common form of S. derby infection is self-healing gastroenteritis, in which, fever lasts for about 2 d and diarrhea for < 7 d. S. derby can often cause bacterial conjunctivitis, pneumonia, endocarditis, peritonitis and urethritis. However, intracranial infections in infants caused by S. derby are rare in clinical practice and have not been reported before in China.
Case Summary:
A 4-mo-old female infant had recurrent fever for 2 wk, with a maximum body temperature of around 39.4°C. Treatment for infectious fever in a local hospital was ineffective, and she was admitted to our hospital. Before admission, there was one sudden convulsion, characterized by unclear consciousness, limb twitching, gaze in both eyes, and slight cyanosis on the face. Cerebrospinal fluid (CSF) culture was positive for Gram-negative bacilli, which conformed to S. derby. After treatment with meropenem and ceftriaxone antibiotics, the patient was discharged home in a clinically stable state after 4 wk of treatment.
Conclusion:
We reported a rare case of S. derby cultured in CSF. S. derby enters the CSF through the blood-brain barrier, causing purulent meningitis. If not treated timeously, it can lead to serious, life-threatening infection.
