Subdural empyema due to Salmonella paratyphi B in an infant: a case report and review of literature

Abstract

Intracranial infection due to Salmonella is uncommon in children. Subdural empyema (SDE) is described with Salmonella typhi as a complication of meningitis. We report a 6-month-old infant with SDE secondary to Salmonella paratyphi B who had presented with prolonged fever and enlarging head. A literature review of Salmonella SDE in infants with respect to clinical course and outcome is presented.

The Epidemiology, Management and Therapeutic Outcomes of Subdural Empyema in Neonates with Acute Bacterial Meningitis

“…To our knowledge, this is the first study to characterize subdural empyema in neonates after acute bacterial meningitis, although some case series can be found in the literature [15,18,19]. This study shows that subdural empyema complicates 18% of all neonates with bacterial meningitis.…”

“…Previous studies found Streptococcus agalactiae, Listeria monocytogenes and Enterobacteriaceae to be important pathogens of subdural empyema in neonates with bacterial meningitis [29,31,32], although some important pathogens, including Haemophilus influenza type b, S. aureus, Salmonella spp. and Neisseria meningitis have been reported in the literature [15,18,19,33]. The incidence of neonatal GBS sepsis has declined in the past decade, mostly due to current infection control and preventive strategies that have worked successfully to reduce maternal colonization and vertical transmission [7,34].…”

“…Most of the cases with subdural empyema were treated with combined antibiotics and surgical intervention in the literature [14][15][16]19]. However, there have been cases successfully treated with a long period of antibiotics plus less invasive treatments, including aspiration, subdural washout, and drainage [20,30,38].…”

“…A recent surveillance study found that subdural effusion and/or empyema was noted in 21.7% of pediatric patients with acute bacterial meningitis, accounting for the most common intracranial complications [17]. However, the presence of subdural empyema may be underdiagnosed, and few studies have focused on this issue [18][19][20][21]. In this study, we aimed to describe the clinical features, microbiology, therapeutic strategies and outcomes of neonatal meningitis complicated with subdural empyema from two tertiary level medical centers in Taiwan.…”