Background: Salmonella species (sp.) is a rare yet challenging causative organism of meningitis in the pediatric population. Salmonella meningitis has been reported to present with a more severe clinical course, poorer outcome, and higher degree of complications and relapses.
Case Illustration: An 8-month-old male infant was admitted to our hospital with a history of focal tonic-clonic seizure, fever, projectile vomiting, and a decrease in consciousness. A head CT scan revealed a brain abscess in the frontal-temporoparietal region. The patient was administered a triple combination of intravenous antibiotics as the empirical treatment, followed by craniotomy for abscess evacuation. The abscess specimen culture isolated the growth of Salmonella sp. Improvement was observed during the hospital stay; however, the patient developed focal epilepsy, communicating hydrocephalus, and subsequent cerebral palsy as sequelae. The infant had a prior admission to the hospital at 6 months old when he was diagnosed with bacterial meningitis caused by Salmonella sp., treated with intravenous antibiotics for 21 days. Although the last cerebrospinal fluid (CSF) culture evaluation was sterile, slight pleocytosis and low glucose on CSF analysis persisted.
Conclusion: Longer antibiotic administration, up to 4-6 weeks, might be considered for treating Salmonella meningitis. Evaluation of CSF culture, along with CSF analysis and neuroimaging studies, should be carefully considered to determine the appropriate duration of treatment.