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ISSN 0035-0052 (Print)

2011, Number 2

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Rev Mex Pediatr 2011; 78 (2)

Meningitis due to enteric salmonella D1

Macías PM, Flores LO, Reina BE

Language: Spanish
References: 22
Page: 71-76
PDF size: 290.14 Kb.


ABSTRACT

Salmonella meningitis is a rare entity with an estimated incidence reported in the literature of 0.3 to 8%, newborn and immunocompromissed patients may be at highest risk. The organism has been associated with severe disease with a high rate of neurological complications and sequela. We present the case of an infant of 5 months of age, with breast feeding and formula, with a history of 3 days with fever up to 39 °C, irritability and the day of admission partial seizures secondary generalized of 30 minutes duration and septic shock, with progressive neurological deterioration and left hemipharesis that required assisted ventilation in the first 24 h of admission. The cranial cat scan (CTS) at admission showed enlargement of third and lateral ventricles, the CSF showed a gramnegative bacillus with a posterior identification of Salmonella enterica subtype D1 in blood and CSF cultures. At 3rd day after a lumbar puncture (LP) was performed with hematic CSF the patient presented endocraneal hypertension with Cushing the CTS showed hypertensive hydrocephalus that required ventriculostomy followed by ventriculoperitoneal shunt. At admission the patient was started on ceftriaxone and at the 5th day it was changed by ciprofloxacine due to a pneumonia associated to ventilator with Burkholderia cepacia isolated. The treatment was given for 5 weeks. The patient was discharged with severe neurological sequela.
Conclusions. Children with Salmonella enteritidis have a high risk of neurological complications that require early diagnosis and management that may improve survival and sequela. Antimicrobial treatment duration most be of at least 25 days to avoid recurrences.


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