SALMONELLA TYPHI – A RARE CAUSE OF MENINGITIS IN A 4.5-MONTHS-OLD BOY

Abstract

Salmonella Typhi is a rare cause of childhood meningitis and only a few cases of Salmonella meningitis have been reported in Pakistan to date. It is difficult to diagnose as initial signs and symptoms resemble meningitis caused by other organisms.  We report a rare case of a 4.5-months-old boy who presented with history of diarrhea for 4 days followed by 2-day history of fever and generalized tonic-clonic seizures. He had bulging anterior fontanelle, hypertonia and hyperreflexia; and was managed as suspected acute bacterial meningitis with intravenous antibiotics and anti-epileptics. Workup revealed blood and cerebrospinal fluid cultures positive for Salmonella Typhi. He was put on mechanical ventilation due to repeated seizures and depressed sensorium on 2^nd day of admission; but later responded to treatment and extubated 4 days later. He was finally discharged on antibiotics for 21 days with no neurological sequelae on follow-up.