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• W2331393811 abstract "Background: Salmonella species are gram negative bacilli with over 2600 serotypes and a worldwide distribution. Non-typhoidal Salmonella (NTS) typically causes self-limiting gastroenteritis, but may become invasive. In sub-Saharan Africa invasive NTS disease is associated with a high mortality, associated with malnutrition, malaria and human immunodeficiency virus (HIV) co-infection. Meningitis due to NTS is a rare complication, with mortality rates over 40% in children. We report three cases of NTS meningitis in paediatric patients in Cape Town (Note: two more cases have been identified). Methods & Materials: A five-year review of NTS cultured from cerebrospinal fluid (CSF) at the Division of Medical Microbiology, Groote Schuur Hospital was performed. This is a tertiary academic microbiology laboratory. The National Health Laboratory Service (NHLS) laboratory information system was searched from 1 July 2010 to 30 June 2015. Retrospective clinical reviews were conducted for these cases including patient history, clinical features, risk factors, treatment and outcomes. Results: From all CSF cultures sent to GSH Microbiology laboratory (n=41865), three cases of NTS meningitis were identified. All three Salmonella meningitis cases were in infants less than one year old. One infant was Zimbabwean with a travel history. All cases were HIV-uninfected: one child was HIV exposed. NTS was isolated from both CSF and blood culture in 2 cases, no blood culture was done on the third. Salmonella enterica serotype Enteritidis (Salmonella Enteritidis) was cultured from two cases and Salmonella Heidelberg from the third. All isolates were susceptible to all antimicrobials tested. One patient died within 72 hours of admission; the remaining two developed neurological complications, including hydrocephalus, hemiplegia and cerebral infarcts. Conclusion: NTS meningitis should be considered in infants if gram negative bacilli are observed in CSF. The prevalence of NTS meningitis in South Africa appears to be low. A third-generation cephalosporin (Ceftriaxone/Cefotaxime) remains the empiric treatment for meningitis. The duration of treatment for gram negative meningitis is usually 21 days. For NTS meningitis at least 4 weeks of therapy may be indicated to prevent relapses. In view of the poor prognosis and high risk of relapse the use of combination therapy with a cephalosporin and fluoroquinolone, which has enhanced intracellular activity, may be required." @default.
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• W2331393811 date "2016-04-01" @default.
• W2331393811 modified "2023-09-26" @default.
• W2331393811 title "Five-year review of non-typhoidal salmonella meningitis in Cape Town, 2010 - 2015" @default.
• W2331393811 doi "https://doi.org/10.1016/j.ijid.2016.02.736" @default.
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