Bacterial meningitis due to Salmonella sp. in a breastfed infant
Keywords:
Salmonella, infant, ColombiaAbstract
Introduction: Meningitis is an inflammation of the membranes surrounding the brain and spinal cord, caused primarily by a bacterial or viral infection that affects the leptomeninges and can enter the body through the mouth or nose and spread to the nervous system. The World Health Organization considers it a public health problem, as there are more than 250,000 cases per year worldwide.
Case presentation: A female patient, 1-month and 26 days old was admitted with a clinical picture of fever, with a tonic-clonic seizure, gaze deviation and generalized rigidity. On physical examination, she was irritable to movement, with a bulging anterior fontanel, crossed gaze, mydriatic pupils, with hyperreflexia, nuchal rigidity and a positive Brudzinski sign. A lumbar puncture was performed for evidence of bacterial meningitis. The cerebrospinal fluid culture showed the presence of Salmonella sp. Antibiotic treatment was given (cefotaxime 150 mg/kg/day and then ceftriaxone 100 mg/kg/day to complete 21 days of antimicrobial therapy), in addition to dexamethasone and phenobarbital, with which an adequate clinical evolution was achieved.
Conclusions: The diagnosis of this case was bacterial meningitis caused by Salmonella sp. This is an uncommon etiologic agent of developing bacterial meningitis in the pediatric population. To our knowledge, no such case has been reported in our country. Bacterial meningitis is associated with a high rate of complications and mortality in children under two years of age and therefore requires early diagnosis and timely treatment.
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1. Ramgopal S, Walker LW, Vitale MA, Nowalk AJ. Factors associated with serious bacterial infections in infants ≤60 days with hypothermia in the emergency department. Am J Emerg Med. 2019;37(6):1139-43. DOI: 10.1016/j.ajem.2019.04.015
2. Fuentes-Antrás J, Ramírez-Torres M, Osorio-Martínez E, Lorente M, Lorenzo-Almorós A, Lorenzo O, et al. Acute Community-Acquired Bacterial Meningitis: Update on Clinical Presentation and Prognostic factors. New Microbiol. 2019 [acceso 05/05/2022];41(4):81–7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30994177/
3. Dubot-Pérès A, Mayxay M, Phetsouvanh R, Lee SJ, Rattanavong S, Vongsouvath M, et al. Management of Central Nervous System Infections, Vientiane, Laos, 2003-2011. Emerg Infect Dis. 2019;25(5):898-910. DOI: 10.3201/eid2505.180914
4. El-Naggar W, Afifi J, McMillan D, Toye J, Ting J, Yoon EW, et al. Epidemiology of meningitis in Canadian Neonatal Intensive Care Units. Pediatr Infect Dis J. 2019;38(5):476-80. DOI: 10.1097/INF.0000000000002247
5. Uribe-Ocampo A, Correa-Pérez S, Rodriguez-Padilla LM, Barrientos-Gómez JG, Orozco-Forero JP. Características clínicas, epidemiológicas y manejo terapéutico de la meningitis pediátrica en dos instituciones de Medellín, Colombia. Rev Univ Salud. 2018; 20(2):121. DOI: 10.22267/rus.182002.116
6. Chacon-Cruz E, Roberts C, Rivas-Landeros RM, Lopatynsky-Reyes EZ, Almada-Salazar LA, Alvelais-Palacios JA. Pediatric meningitis due to Neisseria meningitidis, Streptococcus pneumoniae and Group B Streptococcus in Tijuana, Mexico: active/prospective surveillance, 2005-2018. Ther Adv Infect Dis. 2019;6:2049936119832274. DOI: 10.1177/2049936119832274
7. Patton ME, Stephens D, Moore K, MacNeil JR. Updated Recommendations for Use of MenB-FHbp Serogroup B Meningococcal Vaccine — Advisory Committee on Immunization Practices, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:509-13. DOI: 10.15585/mmwr.mm6619a6
8. Linder KA, Malani PN. Meningococcal Meningitis. JAMA. 2019;321(10):1014. DOI: 10.1001/jama.2019.0772
9. Chen H-M, Wang Y, Su L-H, Chiu C-H. Nontyphoid salmonella infection: microbiology, clinical features, and antimicrobial therapy. Pediatr Neonatol. 2013;54(3):147-52. DOI: 10.1016/j.pedneo.2013.01.010
10. Van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362(2):146-54. DOI: 10.1056/nejmra0804573
11. Mani R, Pradhan S, Nagarathna S, Wasiulla R, Chandramuki A. Bacteriological profile of community acquired acute bacterial meningitis: a ten-year retrospective study in a tertiary neurocare centre in South India. Indian J Med Microbiol. 2007;25(2):108-14. DOI: 10.4103/0255-0857.32715
12. Behravesh CB, Brinson D, Hopkins BA, Gomez TM. Backyard poultry flocks and salmonellosis: a recurring, yet preventable public health challenge. Clin Infect Dis. 2014;58(10):1432-8. DOI: 10.1093/cid/ciu067
13. Mohan A, Munusamy C, Tan YC, Muthuvelu S, Hashim R, Chien SL, et al. Invasive Salmonella infections among children in Bintulu, Sarawak, Malaysian Borneo: a 6-year retrospective review. BMC Infect Dis. 2019;19, 330. DOI: 10.1186/s12879-019-3963-x
14. Varma JK, Molbak K, Barrett TJ, Beebe JL, Jones TF, Rabatsky-Ehr T, et al. Antimicrobial-resistant nontyphoidal Salmonella is associated with excess bloodstream infections and hospitalizations. J Infect Dis. 2005;191(4):554–61. DOI: 10.1086/427263
15. Haydar SM, Hallit SR, Hallit RR, Salameh PR, Faddoul LJ, Chahine BA, et al. Adherence to international guidelines for the treatment of meningitis infections in Lebanon. Saudi Med J. 2019;40(3):260-5. DOI: 10.15537/smj.2019.3.23965
16. Grégoire M, Dailly E, Le Turnier P, Garot D, Guimard T, Bernard L, et al. High-dose ceftriaxone for bacterial meningitis and optimization of administration scheme based on nomogram. Antimicrob Agents Chemother. 2019;63(9):e00634-19. DOI: 10.1128/aac.00634-19
17. Chiu CH, Ou JT. Persistence of Salmonella species in cerebrospinal fluid of patients with meningitis following ceftriaxone therapy. Clin Infect Dis. 1999;28(5):1174-5. DOI: 10.1086/517773
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