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A four-month-old boy developed Salmonella Typhimurium meningitis after initial treatment for pneumonia. Despite antibiotic therapy, the infant succumbed to the infection, highlighting the severity of Salmonella meningitis in neonates.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatal Care
Background:
- Salmonella Typhimurium is a significant cause of bacterial meningitis in infants.
- Early diagnosis and appropriate antibiotic treatment are crucial for managing neonatal meningitis.
Observation:
- A four-month-old boy presented with symptoms of meningitis, including fever, vomiting, stiff neck, and bulging fontanel.
- Cerebrospinal fluid (CSF) and blood cultures confirmed Salmonella Typhimurium infection.
- The infant had a history of staphylococcal pneumonia, pyo-pneumothorax, cardiac failure, and anemia.
Findings:
- The isolated Salmonella Typhimurium strain was sensitive only to trimethoprim-sulfamethoxazole and netilmicin.
- Despite treatment with these antibiotics, the patient's condition deteriorated, leading to expiration.
- Postmortem examination confirmed Salmonella Typhimurium in meningeal tissue and CSF.
Implications:
- This case underscores the critical need for prompt recognition and aggressive management of Salmonella meningitis in infants.
- The limited antibiotic sensitivity observed highlights potential challenges in treating invasive Salmonella infections.
- Further research into effective therapeutic strategies for neonatal Salmonella meningitis is warranted.
Abstract:
A four - month old boy with Salmonella Typhimurium meningitis is presented. This patient was admitted to the hospital with a diagnosis of staphylococcal pneumonia, pyo-pneumothorax, cardiac failure and anemia. He has been treated for 18 days and he was discharged in good condition. Two days after discharge patient was readmitted with a fever, vomiting and feeding problem. In physical examination, stiff neck and bulging of the fontanel were remarkable. Examination of cerebrospinal fluid (CSF) has revealed meningitis and cultures of blood and CSF specimens were positive for S. typhimurium. It was sensitive only to trimethoprim sulphamethoxazole and netilmicin. Trimethoprim sulphamethoxazole (IM) and netilmicin (IV) were given. At the fifth day of this treatment patient expired. Postmortem examination has revealed the same agent in both meninges tissue and CSF cultures.