Abstract
Objective This study aimed to clarify the clinical presentations, acute complications, and
long-term sequelae of Salmonella meningitis in Saudi infants and children.
Methods This retrospective study, conducted from 1999 to 2016, evaluated the neurological
complications and long-term outcomes of children 14 years of age and younger diagnosed
with Salmonella meningitis at King Khalid University Hospital. All affected children had 3 years
of follow-up to assess neurologic complications and mortality.
Results Invasive Salmonella infection occurred in 141 patients. Of those, 14 (10%) had meningitis. The median
age of onset of infection was 4.7 months. The most frequent symptoms at presentation
included fever (100%), seizures (71%), diarrhea, and vomiting (43%). Nontyphoidal
Salmonella species were isolated in all (but one) cerebrospinal fluid samples. Relapse occurred
in four patients owing to inadequate antibiotic duration, although the organisms were
susceptible to ceftriaxone. The majority of patients (86%) developed acute neurologic
complications, including subdural empyema and multiple cerebral infarcts (57%), hydrocephalus
(36%), ventriculitis (29%), and cerebral venous sinus thrombosis (21%). Four patients
(28.5%) died due to Salmonella meningitis complications. Four patients survived with full recovery. Six patients
(60%) had long-term neurologic complications. Hydrocephalus, cerebral palsy, developmental
delay, and epilepsy occurred in five, four, three, and three patients, respectively.
Conclusion Salmonella meningitis results in significant mortality and adverse neurodevelopmental outcomes.
The probability of relapse after an apparent recovery should be considered. Consensus
on antibiotic treatment for Salmonella meningitis is needed.
Keywords
Salmonella
- meningitis - children - infants
