Khurshid Noman, Khan Bilal Ahmed, Bukhari Syed Wasif, Shahid Ashar, Punshi Avinash
Miscellaneous, Dow Medical College, Dow University of Health Sciences, Karachi, PAK.
Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2019 Oct 22;11(10):e5961. doi: 10.7759/cureus.5961.
Meningitis caused by Salmonella enteritidis is an uncommon infection, linked with great mortality and neurological problems, which makes prompt diagnosis and treatment very crucial. Patients of bacterial meningitis present with common symptoms such as headache, fever, altered level of consciousness, and neck rigidity. A positive gram stain or culture of cerebrospinal fluid (CSF) leads to its diagnosis. In this report, we present a case of a 16-year-old male with extensively drug-resistant (XDR) Salmonella typhi meningitis, which was not responsive to initial medical intervention. He was treated with meropenem, imipenem, azithromycin, and metronidazole. Immediate tracheostomy and intubation were performed in the surgical intensive care unit (ICU), as the patient had developed stridor, shortness of breath, tachypnea, tachycardia, and had severely decreased O saturation of 60%. As far as treatment is concerned, third-generation cephalosporins are considered the treatment of choice. In addition, the use of fluoroquinolones and carbapenems, mainly meropenem, has also been described as a therapeutic alternative.
肠炎沙门氏菌引起的脑膜炎是一种罕见的感染,与高死亡率和神经问题相关,这使得及时诊断和治疗至关重要。细菌性脑膜炎患者会出现头痛、发热、意识水平改变和颈部僵硬等常见症状。脑脊液(CSF)革兰氏染色阳性或培养阳性可确诊。在本报告中,我们介绍了一例16岁男性广泛耐药(XDR)伤寒沙门氏菌脑膜炎病例,该病例对初始医疗干预无反应。他接受了美罗培南、亚胺培南、阿奇霉素和甲硝唑治疗。由于患者出现喘鸣、呼吸急促、呼吸频率加快、心动过速且血氧饱和度严重降至60%,在外科重症监护病房(ICU)立即进行了气管切开术和插管。就治疗而言,第三代头孢菌素被认为是首选治疗药物。此外,氟喹诺酮类药物和碳青霉烯类药物,主要是美罗培南,也被描述为一种治疗选择。