Affiliations: Department of Pediatrics, Baylor College of Medicine,
Houston, TX, USA | Department of Pathology, Texas Children's Hospital,
Houston, TX, USA | Department of Molecular Virology and Microbiology,
Baylor College of Medicine, Houston, TX, USA
Note: [] Correspondence: Flor M. Munoz, MD, Baylor College of Medicine,
One Baylor Plaza, BCM-280, Suite 221-D, Houston, TX 77030, USA. Tel.: +1 713
798 5248; Fax: +1 713 798 6802; E-mail: florm@bcm.edu
Abstract: Salmonella spp., a common cause of gastroenteritis, can result in
invasive infections in children. While reported in developing countries,
Salmonella meningitis has rarely been described in the United States. To
evaluate the incidence and clinical characteristics of Salmonella meningitis at
Texas Children's Hospital, we conducted a retrospective chart review to
identify children up to 18 years of age with positive cerebrospinal fluid
cultures for Salmonella from 2000 to 2010. Salmonella meningitis
occurred in 7 of 112 (6.5%) cases of invasive Salmonella infection in
children at our institution. Non-typhi Salmonella species were isolated
in all cerebrospinal fluid samples, but only one had bacteremia. Patients were
otherwise healthy infants under 4 months of age with no travel history. The
most frequent symptoms at presentation included irritability, fever and
diarrhea. Management and treatment regimens were varied. All infants survived
and recovered without sequelae. Patients who received longer duration of
intravenous antibiotics had a longer hospital stay, required central venous
access, and developed side effects from medications. Non-typhi Salmonella
meningitis was exclusively diagnosed in healthy infants younger than 4 months
of age, and was not associated with high morbidity or mortality. Evaluation for
meningitis is warranted in infants with gastroenteritis and systemic symptoms
such as fever and irritability. The management of non-typhi Salmonella
meningitis in children is not standardized and deserves further evaluation.
Keywords: Salmonella, non-typhi, meningitis, infants, United States
