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Extensively Drug-resistant Salmonella typhi Meningitis in a 16-year-old Male.
Cureus 2019; 11(10):e5961C

Abstract

Meningitis caused by Salmonella enteritidis is an uncommon infection, linked with great mortality and neurological problems, which makes prompt diagnosis and treatment very crucial. Patients of bacterial meningitis present with common symptoms such as headache, fever, altered level of consciousness, and neck rigidity. A positive gram stain or culture of cerebrospinal fluid (CSF) leads to its diagnosis. In this report, we present a case of a 16-year-old male with extensively drug-resistant (XDR) Salmonella typhi meningitis, which was not responsive to initial medical intervention. He was treated with meropenem, imipenem, azithromycin, and metronidazole. Immediate tracheostomy and intubation were performed in the surgical intensive care unit (ICU), as the patient had developed stridor, shortness of breath, tachypnea, tachycardia, and had severely decreased O2 saturation of 60%. As far as treatment is concerned, third-generation cephalosporins are considered the treatment of choice. In addition, the use of fluoroquinolones and carbapenems, mainly meropenem, has also been described as a therapeutic alternative.

Authors+Show Affiliations

Miscellaneous, Dow Medical College, Dow University of Health Sciences, Karachi, PAK.Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK.Miscellaneous, Dow Medical College, Dow University of Health Sciences, Karachi, PAK.Internal Medicine, Dow University of Health Sciences, Karachi, PAK.Internal Medicine, Civil Hospital Karachi, Karachi, PAK.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31799097

Citation

Khurshid, Noman, et al. "Extensively Drug-resistant Salmonella Typhi Meningitis in a 16-year-old Male." Cureus, vol. 11, no. 10, 2019, pp. e5961.
Khurshid N, Khan BA, Bukhari SW, et al. Extensively Drug-resistant Salmonella typhi Meningitis in a 16-year-old Male. Cureus. 2019;11(10):e5961.
Khurshid, N., Khan, B. A., Bukhari, S. W., Shahid, A., & Punshi, A. (2019). Extensively Drug-resistant Salmonella typhi Meningitis in a 16-year-old Male. Cureus, 11(10), pp. e5961. doi:10.7759/cureus.5961.
Khurshid N, et al. Extensively Drug-resistant Salmonella Typhi Meningitis in a 16-year-old Male. Cureus. 2019 Oct 22;11(10):e5961. PubMed PMID: 31799097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extensively Drug-resistant Salmonella typhi Meningitis in a 16-year-old Male. AU - Khurshid,Noman, AU - Khan,Bilal Ahmed, AU - Bukhari,Syed Wasif, AU - Shahid,Ashar, AU - Punshi,Avinash, Y1 - 2019/10/22/ PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2019/12/5/medline KW - antibiotic resistance KW - cephalosporin KW - culture KW - meningitis KW - salmonella KW - typhi SP - e5961 EP - e5961 JF - Cureus JO - Cureus VL - 11 IS - 10 N2 - Meningitis caused by Salmonella enteritidis is an uncommon infection, linked with great mortality and neurological problems, which makes prompt diagnosis and treatment very crucial. Patients of bacterial meningitis present with common symptoms such as headache, fever, altered level of consciousness, and neck rigidity. A positive gram stain or culture of cerebrospinal fluid (CSF) leads to its diagnosis. In this report, we present a case of a 16-year-old male with extensively drug-resistant (XDR) Salmonella typhi meningitis, which was not responsive to initial medical intervention. He was treated with meropenem, imipenem, azithromycin, and metronidazole. Immediate tracheostomy and intubation were performed in the surgical intensive care unit (ICU), as the patient had developed stridor, shortness of breath, tachypnea, tachycardia, and had severely decreased O2 saturation of 60%. As far as treatment is concerned, third-generation cephalosporins are considered the treatment of choice. In addition, the use of fluoroquinolones and carbapenems, mainly meropenem, has also been described as a therapeutic alternative. SN - 2168-8184 UR - https://www.unboundmedicine.com/medline/citation/31799097/Extensively_Drug-resistant_Salmonella_typhi_Meningitis_in_a_16-year-old_Male L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31799097/ DB - PRIME DP - Unbound Medicine ER -