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[Meningitis due to Salmonella in the neonatal period]
M E Vázquez-López1, R Pego, C Somoza
1Servicio de Pediatría, Hospital Xeral-Calde, Lugo, España.
Introduction:
Meningitis due to Salmonella is an unusual sign of salmonellosis. Usually Salmonella causes clinical disorders of the digestive tract, but on occasions, especially in babies, may cause focalized infections such as meningitis. Although meningitis due to Salmonella is unusual, it should be remembered because of its gravity, since it has a high morbimortality. It mainly affects neonatal babies and those under 4 months of age. It usually precedes or is accompanied by gastroenteritis and has a rapid clinical course.
Clinical Case:
We present the case of a neonatal baby girl, 17 days old, who was very irritable, had liquid or semi-liquid faeces and high fever of unknown origin with poor response to antipyretic drugs. On lumbar puncture a cloudy liquid, compatible with bacterial meningitis was obtained. Treatment was therefore started immediately with intravenous ampicillin and cefotaxima. CSF culture grew Salmonella which was resistant to ampicillin but sensitive to cefotaxima. Antibiotic treatment was given for 21 days. There was excellent clinical recovery. After eight months of follow-up no sequelae have been seen and her development, both psychomotor, in height and in weight is normal for her age.
Conclusion:
Meningitis due to Salmonella is an unusual condition. Immediate, suitable treatment is essential to obtain satisfactory recovery.
Insights
Salmonella meningitis is a rare but serious infection in infants, often linked to gastrointestinal issues. Prompt antibiotic treatment, like cefotaxime, is crucial for a full recovery without long-term effects.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Salmonella typically causes gastrointestinal illness but can lead to invasive infections like meningitis, particularly in neonates.
- Salmonella meningitis, though uncommon, carries significant morbidity and mortality, primarily affecting infants under four months.
- This condition often presents with or follows gastroenteritis and has a rapid clinical progression.
Observation:
- A 17-day-old neonate presented with irritability, diarrhea, and persistent fever unresponsive to antipyretics.
- Lumbar puncture revealed cloudy cerebrospinal fluid (CSF), indicative of bacterial meningitis.
- CSF culture identified Salmonella, exhibiting resistance to ampicillin but sensitivity to cefotaxime.
Findings:
- The infant received a 21-day course of intravenous ampicillin and cefotaxime.
- The patient demonstrated excellent clinical recovery.
- Eight-month follow-up showed normal psychomotor, physical, and weight development, with no sequelae.
Implications:
- Early diagnosis and appropriate antibiotic therapy are critical for favorable outcomes in Salmonella meningitis.
- This case underscores the importance of considering Salmonella in the differential diagnosis of neonatal meningitis.
- Effective treatment can prevent long-term complications in affected infants.