Brain abscess and epidural empyema caused by Salmonella enteritidis in a child: successful treatment with ciprofloxacin: a case report

Gallbladder Empyema and Epidural Abscess Due to Salmonella Enteritidis After Treatment of Primary Infection: Case Report and Review of the Literature

Nontyphoidal Salmonella can cause gallbladder empyema and disseminated disease in patients with suppressed immune systems. We are reporting a unique case of concomitant gallbladder empyema and epidural abscess due to Salmonella enterica subsp enterica serovar Enteritidis in a patient who was appropriately treated for the primary Salmonella infection complicated by bacteremia. A high degree of suspicion is needed in high-risk patients as timely intervention can avoid life-threatening complications.

A Rare Case of Salmonella Osteomyelitis in Immunocompetent Toddler Without Risk Factors

Salmonella infections are common, though rarely cause disseminated or severe disease in immunocompetent children. We present a case of severe salmonella osteomyelitis and epidural abscess in a patient without significant risk factors. This patient presented over the course of multiple visits with nonspecific symptoms of fever, malaise, and eventual joint pain. As symptoms progressed, the workup was broadened to find the eventual source of infection.

Salmonella brain abscess in an infant

Brain abscess is a potentially life-threatening condition requiring rapid diagnosis and prompt medical and surgical intervention. Various etiological agents associated with different epidemiological backgrounds are implicated, including Gram-positive and Gram- negative bacterial agents as well as anaerobes. Salmonella is rarely reported to be the cause of this medical condition despite being known to cause invasive infections at extremes of age and the fact that this organism is a common cause of other clinical infectious diseases encountered in immunocompromised and immunocompetent individuals. A case of Salmonella brain abscess involving the right posterior parietal region of the brain is described in a 6-month-old infant. The clinical, microbiological, and radiological features, as well as the clinical management and outcome, are presented. This case highlights the slow-progression nature of brain abscess caused by Salmonella species and the challenge in achieving optimal resolution despite initial surgical intervention.

Subgaleal and brain abscesses due to Salmonella enteritidis following craniotomy for giant cell glioblastoma multiforme: A case report and literature review

Background:

Cranial surgical site infections due to Salmonella species are rarely reported. Only eight cases of Salmonella enteritidis infection following intracranial surgery for brain tumor have been reported to date. We describe a unique case of both subgaleal and brain abscesses caused by S. enteritidis following craniotomy for a parafalcine giant cell glioblastoma multiforme. A literature review of the previously published cases is also provided.

Case Description:

A 36-year-old previously healthy man presented with a posterior parietal parafalcine giant cell glioblastoma multiforme. 5 weeks after craniotomy for tumor resection, the patient presented with worsening headache and painful swelling at the cranial operative site. Head computed tomography and magnetic resonance imaging scans revealed both scalp and brain abscesses in the previous surgical site. He was treated with aspiration of the subgaleal abscess and ciprofloxacin antibiotic therapy; he made a full recovery. Cultures of the aspirate identified S. enteritidis, although the primary site of infection was not detected.

Conclusions:

Although postoperative S. enteritidis infections are rare, the large numbers of patients with malignant brain tumors who require tumor resections and receive corticosteroids are at great risk. Adequate drainage (if possible), early isolation of the pathogens, and control of the infection by antibiotic therapy guided by antimicrobial susceptibility testing are vital components to prevent this potentially fatal condition.

Unusual manifestation of Salmonella enterica serotype enteritidis infection in a case of Langerhans cell histiocytosis

Nontyphoidal Salmonella (NTS) are established foodborne pathogens, most commonly reported in cases of gastroenteritis. These pathogens are however, increasingly being implicated in cases of bacteraemia and other extraintestinal manifestations. We report a case of a scalp abscess due to Salmonella enterica serotype Enteritidis, which is a serotype of NTS, in a child suffering from a haematologic malignancy. The child was on steroid and anticancer chemotherapy and developed the abscess secondary to bacteraemia with Salmonella Enteritidis. The abscess was drained and resolved following a course of intravenous antibiotic treatment.

Microbiological spectrum of brain abscess at a tertiary care hospital in South India: 24-year data and review

Intracranial abscesses are life-threatening infections that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Materials and Methods. This is a retrospective analysis of 352 samples from 1987 to 2010 analyzed at a tertiary care hospital in South India from 1987 to 2010, to document the changing trends with time. Results. The age of the patients ranged from 2 to 80 years, a larger number of males being affected. Otogenic infections were the most common cause while cryptogenic abscesses were 20%. Gram stain and culture positivity were 78% each. Gram-positive and negative facultative aerobes and obligate anaerobes were also on the rise. Unusual organisms, like Burkholderia pseudomallei, Salmonella typhi, Nocardia species, Cladosporium bantiana, Fonsecaea pedrosoi, Entamoeba histolytica, and Acanthamoeba were also isolated and/or detected from the brain abscesses aspirate or resected tissue. Summary. New and emerging pathogens associated with brain abscess, especially in immunosuppressed individuals, have renewed the necessity of an early detection, and it will be of great value in appropriate management of patients with brain abscess.

Rare case of intracranial Salmonella enteritidis abscess following glioblastoma resection: Case report and review of the literature

Background:

Worldwide, Salmonella enteritidis (SE) is becoming a common cause of gastrointestinal infections by contaminated food products, mainly eggs. Extra-intestinal manifestations such as brain abscess are more commonly associated with Salmonella typhimurium and are rare in adults. We report the clinical features, treatment outcomes and risk factors predisposing our patient to Salmonella enteritidis brain abscess and discuss relevant literature.

Case Description:

A 57-year-old-man developed SE subdural empyema, abscess and possible ventriculitis following reoperation for progression of a right temporal glioblastoma. He initially presented with rapidly worsening headaches over a few days, with a wound discharge and associated meningeal signs. An emergent wound washout revealed pus in the epidural, subdural space and resection cavity. An external ventricular drain (EVD) was placed and cultures revealed gram negative rods. Timely intervention, EVD, and antibiotics resulted in complete resolution. Nine cases of Salmonella abscess associated with primary brain tumor have been reported in literature, most frequently caused by SE in association with glioblastoma multiforme (GBM). We describe our management and outcome in addition to discussing neurosurgical literature on the reported cases.

Conclusions:

Re-operative tumor surgery has a higher incidence of post-operative infections, with Gram positive cocci being the most common pathogens. Predisposing factors reported for intracranial salmonellosis include compromised immunity, diabetes, HIV, and recent travel. Chronic corticosteroid use, multiple regimens of chemotherapy, and regions of tumor necrosis likely potentiate this rare infection in GBM patients.