Bay Constanza, Jofré Macarena, Kuzmanic Daniela, Aguirre Constanza, Gutiérrez Valentina
Programa de Formación en Pediatría, Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile.
Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Chilena Infectol. 2020 Aug;37(4):470-476. doi: 10.4067/S0716-10182020000400470.
Salmonella spp meningitis is rare in pediatrics. However, it should be especially suspected in children younger than 6 months. The enteric subspecies is the most frequent worldwide, with the Enteritidis serovar being the most important. The complication rate is high, with collections and abscesses predominating. For this reason, neuroimaging is currently recommended for all patients. Even though management is not standardized, there is consensus that first line treatment should be with third generation cephalosporins. Antibiotic resistance is infrequent but increasing, mainly in underdeveloped countries. We present the first case reported in Chile of meningitis by Salmonella Enteritidis in an 11-month-old infant presenting with fever and focused epileptic crisis. Blood culture and cerebrospinal fluid culture were positive. The patient completed four weeks of treatment with ceftriaxone and ciprofloxacin with a good response.
沙门氏菌属脑膜炎在儿科中较为罕见。然而,6个月以下的儿童应特别怀疑患有此病。肠道亚种在全球最为常见,其中肠炎血清型最为重要。并发症发生率很高,以积液和脓肿为主。因此,目前建议对所有患者进行神经影像学检查。尽管治疗方法尚未标准化,但大家一致认为一线治疗应使用第三代头孢菌素。抗生素耐药情况并不常见,但呈上升趋势,主要在不发达国家。我们报告了智利首例11个月大婴儿患肠炎沙门氏菌脑膜炎的病例,该婴儿伴有发热和局灶性癫痫发作。血培养和脑脊液培养均呈阳性。患者接受了四周的头孢曲松和环丙沙星治疗,反应良好。