Obscure Manifestations of Salmonella Subdural Empyema in Children: Case Report and Literature Review

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2010 Sep 8

PMID 20821214

Citations 5

Authors

Kai-Mao Chen

Hsiu-Fen Lee

Ching-Shiang Chi

Fang-Liang Huang

Cheng-Yi Chang

Hao-Chun Hung

Affiliations

Soon will be listed here.

Abstract

Purpose: Salmonella intracranial infections, including subdural empyema and brain abscess, are rare clinical manifestations in children. The aim of this study is to investigate the clinical course of Salmonella subdural empyema in infants and children.

Methods: We report a 9-month-old female infant diagnosed as Salmonella subdural empyema with clinical features of prolonged fever for more than 2 months and episodic focal seizures. Literature published between 1986 and 2010 relevant to Salmonella subdural empyema in children were reviewed. The clinical presentations and laboratory findings were analyzed.

Results: Seventeen cases with Salmonella subdural empyema, including our index case, has been reported with detailed clinical presentation. Fever (17/17; 100%), symptoms and signs of increased intracranial pressure (8/17; 47%), seizures (8/17; 47%), and limb paralysis (8/17; 47%) were the most frequent clinical features. Among these cases, unknown causative organism prior to surgery (11/17; 65%) and prolonged fever for more than 3 weeks (5/17; 29%) were also noticed. Sixteen out of 17 patients (94%) required surgical intervention for treatment. The morbidity rate and mortality rate were 29% (5/17) and 6% (1/17), respectively.

Conclusion: Subdural empyema is considered to be a disease with rapid progression. However, the cases caused by Salmonella species may present a slow disease course. Surgical intervention is sometimes the only way to detect the pathogen.

Citing Articles

First report of salmonella Dublin subdural empyema: A rare presentation of CNS infection.

Bugazia S, Selim A, Sreenivasan A, Rehman M, Mahmoud M IDCases. 2024; 38:e02111.

PMID: 39563682 PMC: 11574787. DOI: 10.1016/j.idcr.2024.e02111.

A Case Report of Meningitis in an Infant: A Rare Entity not to Forget.

Palyvou M, Angeli E, Syrogiannopoulos G, Farmaki E, Tzanoudaki M, Dimitriou G Infect Disord Drug Targets. 2024; 25(1):e250424229335.

PMID: 38676483 DOI: 10.2174/0118715265286206240402050756.

Group D1 Subdural Empyema Mimicking Subdural Hematoma: A Case Report.

Lu H, Yue C, Kung W Infect Drug Resist. 2022; 15:6357-6363.

PMID: 36337934 PMC: 9635384. DOI: 10.2147/IDR.S388101.

Salmonella brain abscess in an infant.

Al-Yaqoobi M, Al-Khalili S, Mishra G Neurosciences (Riyadh). 2018; 23(3):250-253.

PMID: 30008002 PMC: 8015581. DOI: 10.17712/nsj.2018.3.20170200.

Subdural empyema due to Salmonella paratyphi B in an infant: a case report and review of literature.

Williams V, Lakshmikantha K, Nallasamy K, Sudeep K, Baranwal A, Jayashree M Childs Nerv Syst. 2018; 34(11):2317-2320.

PMID: 29748704 DOI: 10.1007/s00381-018-3825-7.

References

Drevets D, Leenen P, Greenfield R . Invasion of the central nervous system by intracellular bacteria. Clin Microbiol Rev. 2004; 17(2):323-47. PMC: 387409. DOI: 10.1128/CMR.17.2.323-347.2004. View

Jain K, Mahapatra A . Subdural empyema due to salmonella infection. Pediatr Neurosurg. 1998; 28(2):89-90. DOI: 10.1159/000028627. View

Hohmann E . Nontyphoidal salmonellosis. Clin Infect Dis. 2001; 32(2):263-9. DOI: 10.1086/318457. View

FARMER T, Wise G . Subdural empyema in infants, children and adults. Neurology. 1973; 23(3):254-61. DOI: 10.1212/wnl.23.3.254. View

Wu T, Chiu N, Huang F . Subdural empyema in children--20-year experience in a medical center. J Microbiol Immunol Infect. 2008; 41(1):62-7. View

Alpuche-Aranda C, Racoosin E, Swanson J, MILLER S . Salmonella stimulate macrophage macropinocytosis and persist within spacious phagosomes. J Exp Med. 1994; 179(2):601-8. PMC: 2191354. DOI: 10.1084/jem.179.2.601. View

Sirinavin S, Chiemchanya S, Vorachit M . Systemic nontyphoidal Salmonella infection in normal infants in Thailand. Pediatr Infect Dis J. 2001; 20(6):581-7. DOI: 10.1097/00006454-200106000-00007. View

Salcedo S, Noursadeghi M, Cohen J, Holden D . Intracellular replication of Salmonella typhimurium strains in specific subsets of splenic macrophages in vivo. Cell Microbiol. 2001; 3(9):587-97. DOI: 10.1046/j.1462-5822.2001.00137.x. View

Osborn M, Steinberg J . Subdural empyema and other suppurative complications of paranasal sinusitis. Lancet Infect Dis. 2006; 7(1):62-7. DOI: 10.1016/S1473-3099(06)70688-0. View

10.

Mahapatra A, Bhatia R . Salmonella intracerebral and subdural abscess--report of two cases. Postgrad Med J. 1987; 63(739):373-5. PMC: 2428484. DOI: 10.1136/pgmj.63.739.373. View

11.

Dill S, Cobbs C, McDonald C . Subdural empyema: analysis of 32 cases and review. Clin Infect Dis. 1995; 20(2):372-86. DOI: 10.1093/clinids/20.2.372. View

12.

Bockova J, Rigamonti D . Intracranial empyema. Pediatr Infect Dis J. 2000; 19(8):735-7. DOI: 10.1097/00006454-200008000-00012. View

13.

Karim M, Islam N . Salmonella meningitis: report of three cases in adults and literature review. Infection. 2002; 30(2):104-8. DOI: 10.1007/s15010-002-2071-8. View

14.

Okudera H, Toba Y, Kyoshima K . Bilateral subdural empyema due to Salmonella enteritidis in an infant. Childs Nerv Syst. 1989; 5(1):45-6. DOI: 10.1007/BF00706749. View

15.

Banerjee A, Pandey P, Devi B, Sampath S, Chandramouli B . Pediatric supratentorial subdural empyemas: a retrospective analysis of 65 cases. Pediatr Neurosurg. 2009; 45(1):11-8. DOI: 10.1159/000202619. View

16.

Bok A, Peter J . Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. J Neurosurg. 1993; 78(4):574-8. DOI: 10.3171/jns.1993.78.4.0574. View

17.

Ghais A, Armano R, Menten R, Mathot M, Zech F, Nassogne M . Meningitis with subdural empyema due to non-typhoid Salmonella in a 9-month-old girl. Eur J Pediatr. 2009; 168(12):1537-40. DOI: 10.1007/s00431-009-0963-7. View

18.

Yen M, Huang Y, Chou M . Non-typhoid Salmonella subdural empyema in children: report of two cases. J Microbiol Immunol Infect. 2000; 32(4):289-91. View

19.

Pasic S, Minic A, Djuric P, Micic D, Kuzmanovic M, Sarjanovic L . Fever of unknown origin in 185 paediatric patients: a single-centre experience. Acta Paediatr. 2006; 95(4):463-6. DOI: 10.1080/08035250500437549. View

20.

Farah J, Kandasamy J, May P, Buxton N, Mallucci C . Subdural empyema secondary to sinus infection in children. Childs Nerv Syst. 2008; 25(2):199-205. DOI: 10.1007/s00381-008-0665-x. View