Meningitis due to Salmonella in the neonatal period
Introduction. Meningitis due to Salmonella is an unusual sign of salmonellosis. Usually Salmonella causes clinical disorders of the digestive tract, but on occasions, especially in babies, may cause focalized infections such as meningitis. Although meningitis due to Salmonella is unusual, it should be remembered because of its gravity, since it has a high morbimortality. It mainly affects neonatal babies and those under 4 months of age. It usually precedes or is accompanied by gastroenteritis and has a rapid clinical course. Clinical case. We present the case of a neonatal baby girl, 17 days old, who was very irritable, had liquid or semi-liquid faeces and high fever of unknown origin with poor response to antipyretic drugs. On lumbar puncture a cloudly liquid, compatible with bacterial meningitis was obtained. Treatment was therefore started immediately with intravenous ampicillin and cefotaxima. CSF culture grew Salmonella which was resistent to ampicillin but sensitive to cefotaxima. Antibiotic treatment was given for 21 days. There was excellent clinical recovery. After eight months of followup no sequelae have been seen and her development, both psychomotor, in height and in weight is normal for her age. Conclusion. Meningitis due to Salmonella is an unusual condition. Immediate, suitable treatment is essential to obtain satisfactory recovery
Caso clínico Presentamos el caso de una niña de 17 días de vida que mostraba una importante irritabilidad, deposiciones líquidas o semilíquidas y fiebre elevada sin un foco claro que explicase su mala respuesta a los antitérmicos. Se realizó una punción lumbar de la que se obtuvo un líquido turbio compatible con meningitis bacteriana, por lo que se instauró inmediatamente tratamiento endovenoso con ampicilina y cefotaxima. El resultado del cultivo del LCR fue Salmonella resistente a ampicilina pero sensible a cefotaxima. Se mantuvo el tratamiento antibiótico durante 21 días. La evolución de la paciente fue muy favorable y tras ocho meses de seguimiento no ha presentado ningún tipo de secuela, y su desarrollo tanto psicomotor como pondoestatural es el adecuado para su edad.
Conclusión La meningitis por Salmonella es una entidad poco frecuente. La instauración inmediata del tratamiento adecuado es la clave para conseguir una buena evolución
