关键词: 沙门菌； 化脓性脑膜炎； 儿童

Abstract: Objective To investigate the clinical characteristics of Salmonella meningitis in children. Methods The clinical data of children with Salmonella positive in cerebrospinal fluid (CSF) culture from 2007 to 2019 were collected, and the relevant literatures were reviewed. Results All patients were female, aged 1 day to 1 year and 2 months, and had no history of unclean diet. The onset symptom of 2 cases was fever, 1 case had watery stools with a little mucous in the course of disease, and 1 case had convulsions. Bilateral Babinski signs were positive in 2 patients and cervical resistance and anterior fontanelle swelling was found in one patient. The WBC in peripheral blood was ( 20 . 1 ~ 25 . 2 ) × 109 /L, and the neutrophil count was ( 15 . 4 ~ 19 . 7 ) × 109 /L. The WBC in CSF was ( 70 ~ 1473 ) × 106 /L, the sugar concentration ranged from 0 . 18 to 3 . 19 mmol/L, and the protein level ranged from 598 . 1 to 6639 . 0 mg/L. Three isolates of Salmonella were detected in CSF cultures, including Salmonella newport, Salmonella paratyphi, and Salmonella typhimurium (one case per each). All strains were sensitive to ceftriaxone, ceftazidime, cefoperazone / sulbactam, meropenem, and imipenem, while one strain was resistant to ampicillin. The blood cultures were all negative. All patients were treated with carbapenems after failed therapies of cefotaxime or ceftriaxone, for a total duration of 3 - 5 weeks. Two patients improved, 1 patient died, and subdural effusion occurred in 1 survivor. Conclusion Salmonella meningitis was rare, but the clinical conditions were serious. Carbapenems might be the first choice for treating Salmonella meningitis.

Key words: Salmonella; purulent meningitis; child