Salmonella Meningitis in an Immunocompetent Adult

Carr, Brendan G.; Weisbein, Jessica L.; Gaieski, David F.

doi:10.1016/j.jemermed.2007.11.046

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…This study demonstrates the sensitivity and specificity of parameters that include the time since the onset of symptoms. Though Carr et al 9 reported a patient with meningitis due to Salmonella who developed an altered mental state after 7 days of fever, we need to be cautious about interpreting our own results, with the present study indicating that patients showing fever symptoms for three or more days at the time of consultation with no disturbance of consciousness are unlikely to be suffering from BM.…”

Section: Discussionmentioning

confidence: 49%

Diagnostic Characteristics of Symptom Combinations over Time in Meningitis Patients

et al. 2013

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Objective: The aim of this study was to investigate diagnostic characteristics to distinguish bacterial meningitis (BM) from aseptic meningitis (AM) in meningitis patients. Indicators from the initial consultation were combined with a measure of time since the onset of fever. Methods: This was a retrospective chart review. We examined the sensitivity and specificity of the clinical information for BM. The diagnostic characteristics for BM were analyzed by considering the duration of fever for each patient at consultation, together with the presence or absence of changes in their mental status. The study examined 117 inpatients diagnosed with meningitis in their clinical record at the time of admission. The patients were admitted into two emergency hospitals in Japan between 2001 and 2011. Meningitis was defined as the presence of five or more cells per mm3 of CSF. Results: Twenty‐five patients were diagnosed with BM and 92 patients with AM. There was no single clinical symptom that could distinguish BM from AM in patients suspected of meningitis. The sensitivity and specificity of the clinical information for fever duration and disturbance of consciousness at consultation were 95.0% and 40.3%, respectively, for BM patients with disturbance of consciousness or with duration of fever less than three days. Thus, the proportion of BM patients without disturbance of consciousness for three or more days after fever onset was only 5%. Conclusions: Patients without disturbance of consciousness for three or more days after fever onset are rarely suffering from BM.

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Section: Discussionmentioning

confidence: 49%

Diagnostic Characteristics of Symptom Combinations over Time in Meningitis Patients

et al. 2013

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“…The blood picture of this patient showed leukocytosis. The serovar reported in this case is S. typhimurium which is the most common causative organism in case of salmonella meningitis followed by S. enteritidis & S. Panama, while few reports of S. Heidelberg, S. Newport also exist [17][18][19].…”

Section: Discussionmentioning

confidence: 74%

“…Salmonella meningitis which was first reported in 1907 has mostly been associated with in patients on long term steroids or with compromised immune system like sickle anemia, AIDS, lymphoma, acute leukemia etc. [13,14]. Children are more likely to contract the infection than adults.…”

Section: Discussionmentioning

confidence: 99%

Emerging Threat of Salmonella typhimurium in Extraintestinal Infections: Cases from a Tertiary Care Hospital in North India

Jain

Pandey

Chatterjee

et al. 2020

IJTDH

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Purpose: Infections due to invasive non-typhoid salmonella can be dangerous and fatal. The mode of infection and the severity varies from the typhoidal fevers. It is important to find the association between clinical features and the infecting serovar to understand the pathophysiology and course of treatment. Methods: In the present study, extra-intestinal specimens (blood, cerebrospinal fluid and pus) from three patients suffering from septicaemia, meningitis and osteomyelitis were received. Micro-biological and biochemical test for species identification and antibiotic susceptibility was done as per standard protocol. Further, PCR based amplification and sequencing of a portion of the flagellin gene (FliC) was done to confirm the serovar. Results: Salmonella enterica was identified from all the three by microbiological and biochemical examination.The sequence of the Flic gene confirmed the serovar to be S. typhimurium. All the patients were treated successfully for the infection by appropriate antibiotic therapy. Conclusion: The study highlights that serovar Typhimurium is common in invasive non-typhoidal salmonellosis and its pathophysiology and virulence factors expression should be understood in various organ types for better treatment options and outcomes.

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“…Rarely it infects immunocompetent patient who has structural abnormalities or chronic conditions such as malignancy, diabetes, or sickle cell disease [10]. Similar cases have been reported in the United States [11] and outside the United states (in Pakistan) as CSF culture proven meningitis or clinical meningitis with CSF pleiocytosis (CSF culture negative) with salmonella bacteremia [12] or in Sweden with CSF culture positive for Salmonella virchow [13].…”

Section: Discussionmentioning

confidence: 83%

Salmonella typhi Meningitis in an Immunocompetent Asian Adult

Nadeem

Elahi

Elhoufi

et al. 2019

Cureus

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Enteric salmonella infections are common in the United States though nonenteric salmonella infections in immunocompetent adults are exceedingly rare in the United States, and meningitis is one of the least common extra-intestinal sites. In addition, it is very unusual for a patient with bacterial meningitis to present with meningitis signs and symptoms of >72 h duration like aseptic meningitis. A 25-year-old Indian male, without any past medical history brought by friends to the ER had fever and irritability for a week. He became increasingly somnolent and confused three days back. Physical exam reveals signs of meningitis and laboratory showed cerebrospinal fluid (CSF) studies suggestive of bacterial meningitis. Culture of CSF grew Salmonella typhi and later on blood culture also grew S. typhi. The patient became worse with cerebral edema and hydrocephalous suspected by change in neurological status and confirmed by ultrasound of eye ball examining optic nerve sheath diameter and CT scan of brain. The patient required neurosurgical intervention and hence external ventricular drain was placed. The patient was also placed on mechanical ventilation. Subsequently he developed ventilator associated pneumonia (VAP) with carbapenem-resistant Pseudomonas aeruginosa. The patient underwent tracheostomy and successfully completed treatment of VAP and was transferred to his home country after four months. Thus we describe a rare case of salmonella meningitis in an immunocompetent adult.

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Salmonella Meningitis in an Immunocompetent Adult

Cited by 6 publications

References 22 publications

Diagnostic Characteristics of Symptom Combinations over Time in Meningitis Patients

Diagnostic Characteristics of Symptom Combinations over Time in Meningitis Patients

Emerging Threat of Salmonella typhimurium in Extraintestinal Infections: Cases from a Tertiary Care Hospital in North India

Salmonella typhi Meningitis in an Immunocompetent Asian Adult

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