J Korean Med Sci.  1999 Jun;14(3):342-344. 10.3346/jkms.1999.14.3.342.

Non-typhoid Salmonella meningitis complicated by a infarction of basal ganglia

• Kim H
• Jeoung JY
• Ham SY
• Kim SR

• KMID: 646318
• DOI: http://doi.org/10.3346/jkms.1999.14.3.342

Abstract

A previously healthy 16-month-old Korean girl with symptoms of fever, vomiting, and generalized tonic seizure was diagnosed to have Group D non-typhoid Salmonella meningitis. The patient was treated with ceftriaxone (100 mg/kg/day) and amikin (22.5 mg/kg/day) initially and ciprofloxacin (30 mg/kg/day) was added later because of clinical deterioration and disseminated intravascular coagulation. Brain CT performed on the second day showed a well-demarcated low density lesion in the right lentiform nucleus and both caudate nuclei, without evidence of increased intracranial pressure. MRI performed on the 11th day confirmed CT scan findings as well as right subdural fluid collection, brain atrophy, and ventriculomegaly. She underwent subdural drainage and later ventriculo-peritoneal shunt operation. Despite receiving intensive treatment, she still has severe neurologic sequelae. Our case shows that infarctions of basal ganglia and thalami are not specific for tuberculous meningitis and that meningitis complicated by infarction is indicative of grave prognosis.

Keyword

Meningitis, bacterial; Salmonella; Cerebral infarction

MeSH Terms

Basal Ganglia Diseases/radiography
Basal Ganglia Diseases/pathology
Basal Ganglia Diseases/complications
Basal Ganglia Diseases/cerebrospinal fluid
Brain/radiography
Brain/pathology
Case Report
Cerebral Infarction/radiography
Cerebral Infarction/pathology
Cerebral Infarction/complications*
Cerebral Infarction/cerebrospinal fluid
Female
Follow-Up Studies
Human
Infant
Magnetic Resonance Imaging
Meningitis, Bacterial/radiography
Meningitis, Bacterial/pathology
Meningitis, Bacterial/complications*
Meningitis, Bacterial/cerebrospinal fluid
Salmonella Infections/complications*
Tomography, X-Ray Computed/methods