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Salmonella meningitis: clinical experience of third-generation cephalosporins
1Department of Paediatrics, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung, Taiwan.
Insights
Prolonged fever in Salmonella meningitis is a key indicator of poor neurological outcomes in children. Prompt treatment with third-generation cephalosporins shows promise, though sequelae remain common.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Salmonella meningitis is a serious infection in children.
- Neurological complications and long-term sequelae are significant concerns.
Purpose of the Study:
- To review outcomes of pediatric patients with Salmonella meningitis.
- To identify prognostic factors and evaluate treatment efficacy.
Main Methods:
- Retrospective review of 15 pediatric patients with Salmonella meningitis.
- Analysis of presenting symptoms, neuroimaging findings, and treatment outcomes.
- Statistical analysis to determine prognostic factors (p < 0.005).
Main Results:
- Prolonged fever (>10 days) was associated with neurological sequelae in 7/8 patients.
- Abnormal neuroimaging findings (ultrasound/CT) were present in 11/15 patients.
- 47% of patients achieved complete recovery with third-generation cephalosporin treatment.
Conclusions:
- Prolonged fever is a significant predictor of poor outcomes in Salmonella meningitis.
- Third-generation cephalosporins are effective, but neurological sequelae and neuroimaging abnormalities are frequent.
- Early diagnosis and management are crucial for improving pediatric Salmonella meningitis outcomes.
Abstract:
Fifteen paediatric patients with Salmonella meningitis were retrospectively reviewed. Presenting symptoms and signs included fever, vomiting, seizures, poor activity, diarrhoea and bulging anterior fontanelle in most patients. Seven out of eight patients with prolonged fever for > 10 days had neurologic sequelae; therefore, prolonged fever is a significant prognostic factor of a poor outcome (p < 0.005). All 15 patients had a brain ultrasound or computed tomography in the acute stage and 11 patients had abnormal findings. The 14 surviving patients were treated with a third-generation cephalosporin for at least 3 weeks. Seven patients (47%) made complete recoveries; two of them were treated solely with a third-generation cephalosporin. Only one mortality (6%) occurred and there were no relapses. In conclusion, high frequencies of prolonged fever, neuroimaging abnormalities and neurologic sequelae were seen in patients with Salmonella meningitis treated with third-generation cephalosporins.