Abstract Ref Number = APCP983
PROBABLE CASE OF SALMONELLA MENINGITIS IN A 16-YEARS OLD GIRL
Carlson Kurniawan,Antony Yaputra,Melanie Mantu
Sumber Waras Hospital Jakarta Sumber Waras Hospital, Jakarta Department of Child Health, Tarakan Hospital, Jakarta
Background : Salmonella meningitis is a rare infection associated with high mortality and neurological complications. Approximately 35 million cases and 500,000 people died of Salmonella typhi infection annually worldwide. Here we describe a probable case of salmonella meningitis in a 16-years-old girl with a history of typhoid fever.
Case Presentation Summary : A sixteen-years-old girl, readmitted to our hospital with a history of typhoid fever one week before. The presentations were altered state of consciousness, nauseous, severe headache, strabismus, dysarthria, but other complaints like fever and seizure were absent. Physical examination revealed a well-nourished girl with a blank, vacant look, her vital signs were stable. From neurological examination, we found paresis of nervus abducens (N. VI) bilaterally, dysarthria, hypertonia and nuchal rigidity were present. The patient could talk but with limited words and difficult to be understood. Chest X-Ray didn’t found any abnormalities or signs of infection, non-contrast brain CT-Scan revealed ventriculomegaly, but meningitis still couldn’t be ruled out. CSF analysis were turbid, cell count of 841, PMN 67%, Glucose CSF:Serum Ratio of 0,08. This patient were treated with ceftriaxone and dexamethasone IV.
Learning Points/Discussion : Salmonella meningitis accounts for a very small proportion of all bacterial meningitis. It has been recommended that Salmonella meningitis should be treated with a third generation cephalosporin for a minimum of three weeks. We suspected this patient to be infected with Salmonella meningitis due to a history of typhoid fever one week prior, but further examination like blood culture, stool culture and CSF culture are needed to confirm this diagnosis.
Keywords: salmonella typhi meningitis typhoid fever