Salmonella Infantis Subdural Empyema in a Healthy Infant.

Abstract

Focal intracranial infections such as brain abscess, subdural empyema, or epidural abscess are unusual manifestations of salmonellosis found almost solely in immuno-compromised patients. We describe an unusual case of an 11-month old immuno-competent girl with a Salmonella Infantis subdural empyema. The case responded well to surgical drainage and long course of antibiotic treatment. Case ReportA previously healthy, 11 month old, female identical twin was admitted to the paediatric unit. She had presented two weeks previously to the General Practitioner with a generalised seizure presumed to be a febrile convulsion. There had been no further seizures but the infant had continued to be febrile and had been commenced on oral amoxicillin 3 days prior to admission. Six to 8 weeks earlier 5 family members had been unwell with a mild diarrhoeal and vomiting illness. Symptoms were self-limiting and the family did not contact health services.On the day of admission her parents were concerned because of an episode of right sided shaking followed by increasing lethargy. On examination she was tachycardic with cool peripheries. She was afebrile. She was lethargic and her head was held fixed to the left. She was poorly responsive with no eye contact or spontaneous vocalisation. Her pupils were of midsize and equally reactive, fundal examination was normal. There was no facial asymmetry but there was paucity of movement,