Abstract：
BACKGROUND: Salmonellae are gram-negative, facultatively anaerobic Enterobacteri-aceae consisting of two species, Salmonella enterica and Salmonella bongori. Invasive diseases, such as meningitis, result in hospitalization, short and long-term complications, and high mortality rates.
METHODS: A 4-month-old baby girl was admitted to a district hospital because of diarrhea and fever. WBC count, urinalysis, urine cultures, and stool cultures were normal. She was treated with intravenous cefuroxime for 5 days. She was discharged on oral cefprozil for 5 days. After the end of therapy, she was admitted again to the same hospital with fever, diarrhea, vomits, and irri-tability. Cerebrospinal fluid examination revealed pleocytosis, while S. enterica was isolated. Em-pirical therapy with ceftriaxone, amikacin, and dexamethasone was started. Because of intracranial hypertension signs, she was transferred to the pediatric intensive care unit of our tertiary hospital. Therapy continued with intravenous ceftriaxone. Brain MRI revealed subarachnoid space dilata-tion. Increased head circumference and pulsating bregmatic fontanel led to a new cerebral MRI, in which ventricular dilatation and extraparenchymal subdural collection were noted. Ceftriaxone was changed to cefotaxime and ciprofloxacin was added. She remained clinically well; her brain MRI, a week later, showed marked improvement, and the course of intravenous antibiotics for 5 weeks was completed. Her baseline immunodeficiency screening tests were normal and repeat MRI two months post-treatment cessation did not reveal the previous abnormalities.
CONCLUSIONS: Invasive Salmonella diseases, such as meningitis, are very uncommon in industrial countries nowadays, and the optimal management is yet not well established. Late onset of com-plications from Salmonella meningitis warrants more thorough neurodevelopmental follow-ups.
METHODS: A 4-month-old baby girl was admitted to a district hospital because of diarrhea and fever. WBC count, urinalysis, urine cultures, and stool cultures were normal. She was treated with intravenous cefuroxime for 5 days. She was discharged on oral cefprozil for 5 days. After the end of therapy, she was admitted again to the same hospital with fever, diarrhea, vomits, and irri-tability. Cerebrospinal fluid examination revealed pleocytosis, while S. enterica was isolated. Em-pirical therapy with ceftriaxone, amikacin, and dexamethasone was started. Because of intracranial hypertension signs, she was transferred to the pediatric intensive care unit of our tertiary hospital. Therapy continued with intravenous ceftriaxone. Brain MRI revealed subarachnoid space dilata-tion. Increased head circumference and pulsating bregmatic fontanel led to a new cerebral MRI, in which ventricular dilatation and extraparenchymal subdural collection were noted. Ceftriaxone was changed to cefotaxime and ciprofloxacin was added. She remained clinically well; her brain MRI, a week later, showed marked improvement, and the course of intravenous antibiotics for 5 weeks was completed. Her baseline immunodeficiency screening tests were normal and repeat MRI two months post-treatment cessation did not reveal the previous abnormalities.
CONCLUSIONS: Invasive Salmonella diseases, such as meningitis, are very uncommon in industrial countries nowadays, and the optimal management is yet not well established. Late onset of com-plications from Salmonella meningitis warrants more thorough neurodevelopmental follow-ups.
摘要：
背景：沙门氏菌为革兰氏阴性，兼性厌氧肠杆菌科细菌由两个物种组成，肠沙门氏菌和邦戈里沙门氏菌。侵袭性疾病,比如脑膜炎，导致住院，短期和长期并发症，和高死亡率。
方法：一名4个月大的女婴因腹泻和发热入院。白细胞计数,尿液分析,尿液培养物,粪便培养正常。她用头孢呋辛静脉注射治疗5天。她口服头孢丙齐出院5天。治疗结束后,她因发烧再次住进了同一家医院，腹泻,呕吐物,和怪癖。脑脊液检查显示细胞增多，而S.enterica被隔离。头孢曲松治疗，阿米卡星，和地塞米松开始。因为颅内高压的迹象，她被转移到我们三级医院的儿科重症监护室。继续静脉注射头孢曲松治疗。脑MRI显示蛛网膜下腔扩张。头围的增加和脉冲状的fontanel导致了新的脑MRI，其中注意到心室扩张和实质外硬膜下收集。将头孢曲松改为头孢噻肟，并加入环丙沙星。她的临床状况很好；她的脑部MRI，一周后,显着改善，并完成了为期5周的静脉抗生素疗程。她的基线免疫缺陷筛查测试正常，停止治疗后两个月重复MRI未发现先前的异常。
结论：侵袭性沙门氏菌病，比如脑膜炎，在当今的工业国家中很少见，优化管理尚未建立。沙门氏菌脑膜炎的晚期并发症需要更彻底的神经发育随访。
方法：一名4个月大的女婴因腹泻和发热入院。白细胞计数,尿液分析,尿液培养物,粪便培养正常。她用头孢呋辛静脉注射治疗5天。她口服头孢丙齐出院5天。治疗结束后,她因发烧再次住进了同一家医院，腹泻,呕吐物,和怪癖。脑脊液检查显示细胞增多，而S.enterica被隔离。头孢曲松治疗，阿米卡星，和地塞米松开始。因为颅内高压的迹象，她被转移到我们三级医院的儿科重症监护室。继续静脉注射头孢曲松治疗。脑MRI显示蛛网膜下腔扩张。头围的增加和脉冲状的fontanel导致了新的脑MRI，其中注意到心室扩张和实质外硬膜下收集。将头孢曲松改为头孢噻肟，并加入环丙沙星。她的临床状况很好；她的脑部MRI，一周后,显着改善，并完成了为期5周的静脉抗生素疗程。她的基线免疫缺陷筛查测试正常，停止治疗后两个月重复MRI未发现先前的异常。
结论：侵袭性沙门氏菌病，比如脑膜炎，在当今的工业国家中很少见，优化管理尚未建立。沙门氏菌脑膜炎的晚期并发症需要更彻底的神经发育随访。
