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Salmonella enterica serotype Agona in infant with meningitis and cerebral abscess

Meor Jamaludin, Wan Husna Barakah and Kamarudin, Norhidayah and Nik Ismaiddin, Nik Hazzaymey and Zainol Rashid, Zetti (2023) Salmonella enterica serotype Agona in infant with meningitis and cerebral abscess. Malaysian Journal of Pathology, 45 (3). p. 558. ISSN 0126-8635

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Introduction: Salmonella meningitis is an uncommon form of intracranial infection, particularly in infants. It remains a threat with severe complications. Case report: A 6-month-old girl presented with fever, vomiting and seizure. Due to impending status epilepticus, she was intubated and empirically treated for meningoencephalitis. The patient had no sick contact but started consuming formula milk in addition to breastfeeding before the onset of symptoms. Neurological examination revealed hypertonia of all four limbs and the contrast CT brain reported as asymmetrical bilateral thalamic changes, white matter lesion and cerebral oedema. Her blood and cerebrospinal fluid cultures yielded gram negative rod, non-fermenter organism with abundant hydrogen sulphide, positive for O and H antigen but negative for Vi antigen. Vitek 2.0 (BioMérieux, USA) named the organism as Salmonella spp. The serotyping test (Bio-Rad, USA) revealed Salmonella enterica serotype Agona. The organism was resistant to ampicillin, susceptible to amoxicillin-clavulanate, ceftriaxone and ciprofloxacin. Despite seven days on intravenous ceftriaxone, the patient had persistent temperature and MRI brain showed bilateral deep grey and white matter abscess and frontotemporal empyema. The patient’s condition was improved after 4 weeks of intravenous ceftriaxone and 3 weeks of intravenous ciprofloxacin before being transferred to another hospital. The antimicrobial was continued for another 3 weeks before being discharged home. Discussion: Salmonella spp. infection has been linked to contaminated breast milk. Salmonella Agona can survive powdered milk products up to 180 days. Multiple outbreaks of Salmonella Agona in infant milk products had been reported in France. The knowledge on proper milk storage and handling can reduce risk of infection.

Item Type: Article (other)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RB Pathology
R Medicine > RJ Pediatrics > RJ251 Newborn infants. Neonatology
R Medicine > RJ Pediatrics > RJ370 Disease of children
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Kulliyyah of Medicine > Department of Pathology & Lab Medicine
Depositing User: Dr. Wan Husna Barakah Meor Jamaludin
Date Deposited: 26 Feb 2024 09:05
Last Modified: 26 Feb 2024 09:17
URI: http://irep.iium.edu.my/id/eprint/110892

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