Abstract
BackgroundSalmonella meningitis remains a threat to children below two years of age in both developing and developed countries. However, information on such infections has not been well characterized. We analyzed data related to twelve years of experience in order to clarify the comprehensive features of Salmonella meningitis in our patients, including admission characteristics, acute complications, and long-term outcome.MethodsThe records of patients with spontaneous Salmonella meningitis from 1982 to 1994 were retrospectively reviewed. The long-term outcome was prospectively determined for survivors at school age by the developmental milestones reported by their parents and detailed neurological evaluation along with intelligence, hearing, visual, speech and language assessments.ResultsOf the twenty-four patients, seizures were noted in fifteen (63%) before admission and thirteen (54%) during hospitalization. Acute complications mainly included hydrocephalus (50%), subdural collection (42%), cerebral infarction (33%), ventriculitis (25%), empyema (13%), intracranial abscess (8%), and cranial nerve palsy (8%). Three patients (13%) died during the acute phase of Salmonella meningitis. The twenty-one survivors, on whom we followed up at school age, have sequelae consisting of language disorder (52%), motor disability (48%), intelligence quotient < 80 (43%), epilepsy (33%), sensorineural hearing loss (17%), visual deficits (10%), abducens nerve palsy (5%), microcephaly (5%), and hydrocephalus (5%). Overall, good outcome was noted in six (28.6%) of twenty-one survivors, mild sequelae in three (14.2%), moderate in six (28.6%), and severe in six (28.6%).ConclusionSalmonella meningitis in neonates and infants had a wide spectrum of morbidity and acute complications, leading to a complicated hospital course and subsequently a high prevalence of permanent adverse outcome. Thus, early recognition of acute complications of Salmonella meningitis and a follow-up plan for early developmental assessment of survivors are vital.
Highlights
Salmonella meningitis remains a threat to children below two years of age in both developing and developed countries
Comprehensive information regarding Salmonella meningitis, including clinical features, complications, and long-term sequelae among survivors has not been well characterized. To clarify these systemic features, long-term outcomes of Salmonella meningitis occurring in neonates and infants primarily admitted to Changhua Christian Hospital from 1982 to 1994, the clinical characteristics of the disease present at hospital admission were retrospectively reviewed, and a follow-up assessment of patients at school age was prospectively undertaken
After 1994, only a few cases with Salmonella meningitis were collected in our hospital due to public health improvements in Taiwan, and they were referred by local medical care
Summary
Salmonella meningitis remains a threat to children below two years of age in both developing and developed countries Information on such infections has not been well characterized. We analyzed data related to twelve years of experience in order to clarify the comprehensive features of Salmonella meningitis in our patients, including admission characteristics, acute complications, and long-term outcome. Comprehensive information regarding Salmonella meningitis, including clinical features, complications, and long-term sequelae among survivors has not been well characterized To clarify these systemic features, long-term outcomes of Salmonella meningitis occurring in neonates and infants primarily admitted to Changhua Christian Hospital from 1982 to 1994, the clinical characteristics of the disease present at hospital admission were retrospectively reviewed, and a follow-up assessment of patients at school age was prospectively undertaken
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