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Unusual aspects of Salmonella meningitis
Abstract:
Two cases of salmonella meningitis that demonstrate unusual clinical and epidemiologic features are reported. The first case was a two-month-old infant with relapsing salmonella meningitis in whom ECHO 2 virus and S. enteritidis grew in mixed culture from cerebrospinal fluid. The second case was a five-month-old with typhoid meningitis. Although this patient eventually responded to chloramphenical, repeated CSF cultures grew S. typhi despite his receiving high dose parenteral therapy with ampicillin and chloramphenicol. Stool cultures disclosed that the patient's mother was an asymptomatic carrier of S. typhi. Nine days after the positive stool culture, the mother developed S. typhi bacteremia.
Insights
Two unusual Salmonella meningitis cases highlight diagnostic challenges. One infant experienced relapsing meningitis with ECHO 2 virus, while a second infant had typhoid meningitis with persistent S. typhi despite treatment.
Area of Science:
- Infectious Diseases
- Pediatric Neurology
- Microbiology
Background:
- Salmonella meningitis is a rare but serious infection in infants.
- Unusual presentations and treatment challenges warrant further investigation.
Observation:
- A two-month-old infant presented with relapsing Salmonella meningitis, co-infected with ECHO 2 virus.
- A five-month-old infant had typhoid meningitis with persistent S. typhi bacteremia despite high-dose ampicillin and chloramphenicol therapy.
Findings:
- Mixed viral and bacterial meningitis can occur in infants.
- Asymptomatic carriers of S. typhi can transmit the pathogen, leading to severe infant illness.
- Persistent S. typhi bacteremia may occur even with appropriate antibiotic treatment.
Implications:
- Highlights the need for comprehensive diagnostic approaches in infant meningitis.
- Underscores the importance of identifying asymptomatic carriers in managing Salmonella infections.
- Suggests potential for novel therapeutic strategies for resistant Salmonella strains.