Salmonella meningitis with hydrocephalus as complication in children: A case series
Departement of Child Health, Medical Faculty of Udayana University Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia.
Research Article
GSC Advanced Research and Reviews, 2023, 15(03), 242–246.
Article DOI: 10.30574/gscarr.2023.15.3.0269
Publication history:
Received on 08 May 2023; revised on 17 June 2023; accepted on 20 June 2023
Abstract:
Background: Bacterial meningitis by salmonella serotype is a rare infection among neonates and young children. The treatment of salmonella meningitis requires bactericidal agents that are capable of penetrating into cerebrospinal fluid (CSF). Acute complications of bacterial meningitis mainly include hydrocephalus, subdural collection, cerebral infarction, ventriculitis, empyema, intracranial abscess and cranial nerve palsy.
Two Cases Presentation: First case, 1 months-old boy brought to the general hospital with chief complaint of fever. Patient had decreased of consciousness and bulging of anterior fontanella. Analysis of cerebrospinal fluid (CSF) showed Pandy test (+4) and None test (+4), high protein 369 mg/dl (mononuclear 44%, polymorphonuclear 56%), liquor glucose 2 mg/dl, CSF culture and blood culture resulted salmonella. Electrolyte and blood sugar was normal, complete blood count showed leukocytes 13.96x 103/µL and mild normochromic normocytic anemia. Head CT scan revealed communicating hydrocephalus. Second case, 6 months-old boy brought to general hospital with seizure as chief complaint. Cerebrospinal fluid (CSF) analysis showed Pandy test (+4) and None test (+4), high protein 569 mg/dL, liquor glucose 26 mg/dL, CSF culture and blood culture results found salmonella sp. Head CT scan revealed subdural hygroma at frontoparietal. Patient was treated by 3rd generation of cephalosporins (ceftriaxone) for 4 weeks. Patient discharge from hospital.
Summary: Management of salmonella meningitis include administration of empiric antibiotic, supportive treatment and management of complication. High dose of antibiotic is given empirically without waiting for the results of culture.
Learning Points: Clinical manifestations and outcome of meningitis salmonella
Keywords:
Salmonella meningitis; Outcomes; Children; Anemia
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Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0
