- Email: [email protected]
Salmonella enteritidis brain abscess: case report and review
Clinical Neurology and Neurosurgery 102 (2000) 236 – 239 www.elsevier.com/locate/clineuro
Case report
Salmonella enteritidis brain abscess: case report and review Juan C. Sarria, Ana M. Vidal, Robert C. Kimbrough III * Department of Internal Medicine, Di6ision of Infectious Diseases, Texas Tech Uni6ersity Health Sciences Center, 3601 4th street, Lubbock, TX 79430, USA Received 4 April 2000; received in revised form 4 July 2000; accepted 4 July 2000
Abstract Intracranial infections are unusual manifestations of salmonellosis. Even with adequate medical and surgical interventions these infections are often associated with significant morbidity and mortality. We report a case of brain abscess caused by Salmonella enteritidis associated with a brain neoplasm and review previous reports in the literature. © 2000 Elsevier Science B.V. All rights reserved. Keywords: Brain abscess; Salmonella enteritidis; Intracranial infections
1. Introduction Salmonella enteritidis is the most frequently isolated Salmonella species in Europe and the US [1]. Invasive S. enteritidis disease is not rare, and although primary bacteremias account for most of these infections, the potential for the organism to cause focal suppurative complications is well known [2]. In this report we describe a case of S. enteritidis brain abscess associated with a glioblastoma multiforme and review previous reports in the literature.
2. Case report A 58-year-old female with no significant past medical history presented to her local hospital with right-sided weakness and increasing somnolence for 1 month. A few hours after admission she developed a fever of 102°F, neck rigidity, third cranial nerve palsy, rightsided hemiparesis, and coma. Computed tomography (CT) scan of the head revealed a left frontal ring-enhancing lesion with extension across the mid-line and * Corresponding author. Tel.: +1-806-7433155; fax: + 1-8067433148. E-mail address: [email protected] (R.C. Kimbrough III).
evidence of transtentorial herniation. She was immediately intubated and treated with diuretics and broad spectrum antibiotics. She was transferred to a tertiary care center for neurosurgical evaluation. Aspiration of the lesion through a precoronal burr hole yielded 35 ml of purulent necrotic material. A drain was left in place. Cultures of the material grew Salmonella enteritidis. Ceftazidime, which had been initiated the day of her transfer was continued based upon sensitivities. Blood, urine, and stool cultures were negative. The patient’s level of consciousness improved and she was extubated, however, 48 h later she deteriorated. Repeated CT scan demonstrated persistent mass effect and edema. The possibility of an underlying neoplasm was entertained. The patient underwent left frontal craniotomy and a large amount of purulent material was drained. Cultures from this material were negative. The abscess cavity was irrigated and barbotaged thoroughly with antibiotic solution. The craniotomy was tolerated well, however, clinical improvement was not seen. Repeated CT scan continued to demonstrate a mass lesion with little change in size. Lack of appropriate response to 6 weeks of ceftazidime prompted a second craniotomy with biopsy which confirmed the diagnosis of glioblastoma multiforme. Antineoplasic therapy was not given in view of the patient’s poor condition. She went into respiratory arrest and expired 52 days after her transfer. An autopsy was not performed.
0303-8467/00/$ - see front matter © 2102 Elsevier Science B.V. All rights reserved. PII: S 0 3 0 3 - 8 4 6 7 ( 0 0 ) 0 0 0 9 9 - 8
3 weeks/M
28 years/M
47 years/M
78 years/M
49 years/F
24 years/M
59 years/M
8 months/M
43 years/M
4 weeks/F
58 years/F
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
PR
Character/location
Clinical manifestations
Single/temporal
Single/parietal
Glioblastoma multiforme
IgA and IgG1 subclass deficiency, bacteremia, meningitis
Bacteremia, meningitis
Gastroenteritis
Single/frontal
Multiple/bifrontal
Single/parietal
Single/left hemisphere
Ampicillin/4 weeks, chloramphenicol/4 weeks
Cefotaxime/8 weeks, chloramphenicol/3 weeks, ciprofloxacin/5 weeks Chloramphenicol/6 weeks, TMP-SMZ/6 weeks
Antimicrobial regimenb/duration
Penicillin/2 weeks, streptomycin/2 weeks, chloramphenicol/4 weeks Fever, confusion, headache Cefotaxime/3 weeks, oral ciprofloxacin/4 months Fever, irritability, signs of Cefotaxime/9 weeks, raised intracranial pressure, ciprofloxacin/10 weeks, hydrocephalus ampicillin/5 weeks, chloramphenicol/2 weeks, metronidazole/2 weeks Fever, decreased sensorium, Ceftazidime/6 weeks hemiparesis, III cranial nerve palsy
Fever, restlessness, bulging fontanelles, tremors
Cefotaxime/2 days, ampicillin/2 days, amikacin/2 days Sepsis, decreased sensorium Cefotaxime/3 weeks, gentamycin/1 week, ceftazidime/6 weeks Fever, decreased sensorium, Ofloxacin/6 days, VI cranial nerve palsy cefotaxime/6 days, ceftazidimec, amikacinc, ciprofloxacinc Fever, neck mass Cefotaximec, metronidazolec
Multiple/occipital and Septic shock, decreased biventricular sensorium, seizures
Diabetes mellitus, Multiple/frontal and gallbladder adenoCA, temporal cholelithiasis, gastroenteritis
Glioblastoma multiforme, steroid therapy, bacteremia, meningitis Excision brain astrocytoma, steroid therapy, bacteremia, meningitis Excision glioblastoma multiforme, steroid therapy, bacteremia, meningitis
Subarachnoidal Multiple/bifrontal and Fever, seizures, jaundice hemorrhage, gastroenteritis, occipital bacteremia, meningitis Excision metastatic brain Single/occipital Fever, headache, vomiting, tumor, bacteremia papilledema, quadrantanopsia AIDS, IVDA, Single/frontal Fever, headache, decreased gastroenteritis, bacteremia, sensorium meningitis
Associated conditions
Yes
Yes
No
Yes
No
Yes
Yes
No
No
Yes
Yes
Surgical drainage
Died
Recovered/2 years
Recovered/6 months
Recovered after excision concurrent mycotic aneurysm carotid artery/6 months Recovered/2 years
Recovered/NS
Residual hemiparesis/NS
Relapsed, treated with ampicilin, TMP-SMZ and drainage/died 7 weeks later of pneumonitis Died
Recovered/NS
Recovered, slightly delayed development/2 years
Outcome/length of follow-up
b
Abbreviations: AIDS, acquired immunodeficiency syndrome; IVDA, intravenous drug abuse; TMP-SMZ, trimetroprim-sulfamethoxazole; NS, not stated; PR, present report. Given intravenously unless otherwise specified. c Duration of treatment not provided.
a
Age/sex
Reference
Table 1 Clinical characteristics of 11 patients with S. enteritidis brain abscessa
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239 237
238
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239
3. Discussion Intracranial infections are unusual manifestations of salmonellosis and brain abscess caused by S. enteritidis is particularly rare. We reviewed the worldwide medical literature by the use of MEDLINE back to 1966 and the references of retrieved articles, and found reports of ten patients with brain abscess caused this organism [3 – 12]. The clinical characteristics of these cases and our case are outlined in Table 1. A variety of predisposing factors have been described in patients with Salmonella intracranial infections [3– 5]. These include primary or metastatic brain tumors, subarachnoid hemorrhage, neurosurgical procedures, steroid use, diabetes mellitus, immunoglobulin deficiencies, and HIV infection. The location of the abscess and the clinical features of these patients did not differ from those with brain abscess caused by other organisms. Fulminant presentations [6] and relapses [5,7] occurred. Of the 11 cases described here, only four had antecedent gastroenteritis caused by S. enteritidis, eight were bacteremic, and seven had meningitis (Table 1). Because a history of gastroenteritis with positive stool cultures for S. enteritidis is not uniformly present and cerebrospinal fluid (CSF) analysis, if obtained, may be normal, the diagnosis is often unsuspected or delayed. Early neuroimaging studies and in some cases diagnostic aspiration of the abscess fluid are required to make a prompt diagnosis. Lumbar puncture is nondiagnostic and is contraindicated [13]. The use of an adequate antimicrobial regimen combined with early surgical drainage will result in the best probability for cure [3,4,7,8,12]. The choice of antibiotics is complicated by the increasing prevalence of resistance among Salmonella spp. to ampicillin, trimetroprim-sulfamethoxazole, chloramphenicol, thirdgeneration cephalosporins, and fluoroquinolones [14– 16]. Furthermore, strains resistant to multiple agents have been reported [16,17]. Third-generation cephalosporins are the most consistently used agents to treat central nervous system (CNS) infections caused by Salmonella spp. Chloramphenicol should be considered a reasonable alternative since it exhibits excellent in vitro activity against most Salmonella strains and penetrates the CSF well, however, an overstated fear of toxicity has limited its more widespread use [4]. Aminoglycosides are clinically ineffective despite their in vitro activity, perhaps because their poor CNS penetration and lack of activity against intracellular Salmonella. Fluoroquinolones are highly active against most Salmonella strains and penetrate the CSF well. Levels of ciprofloxacin in the CSF are usually well above the MIC for most Salmonella spp. [18]. Although clinical data is still limited [3,11,12,18 – 21] these agents should be considered good alternatives in infections caused by
strains resistant to other antimicrobials. Ultimately, agents with little demonstrated resistance and adequate CNS penetration should be selected to treat these complicated infections, and courses of at least 6 weeks are indicated to prevent relapses [7]. Mortality rates of 40–60% are reported for patients with intracranial infections caused by Salmonella spp., and a significant number of survivors develop permanent neurologic sequelae [2,22]. Of the 11 patients described here, nine survived and six recovered without neurologic deficits. These more favorable results probably reflect the fact that most of these patients received prompt antimicrobial and surgical treatment. A less favorable outcome is obtained when a co-morbid condition such as an intracranial neoplasm or HIV infection is present. References [1] Hogue A, White P, Guard-Petter J, et al. Epidemiology and control of egg-associated Salmonella enteritidis in the United States of America. Rev Sci Tech 1997;16:542 – 53. [2] Cohen JI, Barlett JA, Corey RG. Extraintestinal manifestations of Salmonella infection. Medicine 1987;66:349 – 88. [3] Wessalowski R, Thomas L, Kivit J, Voit T. Multiple brain abscesses caused by Salmonella enteritidis in a neonate: successful treatment with ciprofloxacin. Pediatr Infect Dis J 1993;12:633 – 8. [4] Rodriguez RE, Valero V, Watanakunakorn C. Salmonella focal intracranial infections: review of the world literature (1884– 1984) and report of an unusual case. Rev Infect Dis 1986;8:31– 41. [5] Fraimow HS, Wormser GP, Coburn KD, Small CB. Salmonella meningitis and infection with HIV. AIDS 1990;4:1271 –3. [6] Noguerado A, Cabanyes J, Vivancos J, et al. Abscess caused by Salmonella enteritidis within a glioblastoma multiforme. J Infect 1987;15:61 – 3. [7] Fiteni I, Ruiz FJ, Crusells MJ, Sanjoaquin I, Guillen G. Infection multifocale du systeme nerveux central a Salmonella enteritidis: efficacite des nouvelles cephalosporines. Presse Med 1995;24:309 – 11. [8] Bossi Ph, Mion G, Brinquin L, Bonsignour JP. Abces cerebral postoperatoire a Salmonella enteritidis. Presse Med 1993;22:130. [9] Lloret MD, Escudero JR, Hospedales J, Viver E. Mycotic aneurysm of the carotid artery due to Salmonella enteritidis associated with multiple brain abscesses. Eur J Vasc Endovasc Surg 1996;12:250 – 2. [10] Brzezinski J, Planeta-Malecka I, Zierski J, Bielinska W. Ropien mozgu w przebiegu zakazenia paleczka Salmonella enteritidis 8-miesiecznego dziecka. Pediatr Pol 1969;44:223 – 6. [11] Bonvin P, Ejlertsen T, Dons-Jensen H. Brain abscess caused by Salmonella enteritidis in an immunocompetent adult patient: successful treatment with cefotaxime and ciprofloxacin. Scand J Infect Dis 1998;30:632 – 4. [12] Workman MR, Price EH, Bullock P. Salmonella meningitis and multiple cerebral abscesses in an infant. Int J Antimicrob Agents 1999;13:131 – 2. [13] Chun CH, Johnson JD, Hofstetter M, Raff MJ. Brain abscess. A study of 45 consecutive cases. Medicine (Baltimore) 1986;65:415 – 31. [14] Herikstad H, Hayes PS, Hogan J, Floyd P, Snyder L, Angulo FJ. Ceftriaxone-resistant Salmonella in the United States. Pediatr Infect Dis J 1997;16:904 – 5.
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239 [15] Herikstad H, Hayes P, Mokhtar M, Fracaro ML, Threlfall EJ, Angulo FJ. Emerging quinolone-resistant Salmonella in the United States. Emerg Infect Dis 1997;3:371–2. [16] Lee LA, Puhr ND, Maloney EK, Bean NH, Tauxe RV. Increase in antimicrobial-resistant Salmonella infections in the United States, 1989 – 1990. J Infect Dis 1994;170:128–34. [17] Cherubin CE. Antibiotic resistance to Salmonella in Europe and the United States. Rev Infect Dis 1981;3:1105–26. [18] Scheld WM. Quinolone therapy for infections of the central nervous system. Rev Infect Dis 1989;11(Suppl. 5):S1194– 202. [19] Bhutta ZA, Farooqui BJ, Sturm AW. Eradication of a multiple drug resistant Salmonella paratyphi A causing meningitis with
.
239
ciprofloxacin. J Infect 1992;25:215 – 9. [20] Ragunathan PL, Potkins DV, Watson JG, Kearns AM, Carroll A. Neonatal meningitis due to Salmonella typhimurium treated with ciprofloxacin. J Antimicrob Chemother 1990;26:727–8. [21] Visudhiphan P, Chiemchanya S, Visutibhan A. Salmonella meningitis in Thai infants: clinical case reports. Trans R Soc Trop Med Hyg 1998;92:181 – 4. [22] Kinsella TR, Yogey R, Shulman ST, Gilmore R, Chadwick EG. Treatment of Salmonella meningitis and brain abscess with the new cephalosporins: two case reports and review of the literature. Pediatr Infect Dis J 1987;6:476 – 80.
Case report
Salmonella enteritidis brain abscess: case report and review Juan C. Sarria, Ana M. Vidal, Robert C. Kimbrough III * Department of Internal Medicine, Di6ision of Infectious Diseases, Texas Tech Uni6ersity Health Sciences Center, 3601 4th street, Lubbock, TX 79430, USA Received 4 April 2000; received in revised form 4 July 2000; accepted 4 July 2000
Abstract Intracranial infections are unusual manifestations of salmonellosis. Even with adequate medical and surgical interventions these infections are often associated with significant morbidity and mortality. We report a case of brain abscess caused by Salmonella enteritidis associated with a brain neoplasm and review previous reports in the literature. © 2000 Elsevier Science B.V. All rights reserved. Keywords: Brain abscess; Salmonella enteritidis; Intracranial infections
1. Introduction Salmonella enteritidis is the most frequently isolated Salmonella species in Europe and the US [1]. Invasive S. enteritidis disease is not rare, and although primary bacteremias account for most of these infections, the potential for the organism to cause focal suppurative complications is well known [2]. In this report we describe a case of S. enteritidis brain abscess associated with a glioblastoma multiforme and review previous reports in the literature.
2. Case report A 58-year-old female with no significant past medical history presented to her local hospital with right-sided weakness and increasing somnolence for 1 month. A few hours after admission she developed a fever of 102°F, neck rigidity, third cranial nerve palsy, rightsided hemiparesis, and coma. Computed tomography (CT) scan of the head revealed a left frontal ring-enhancing lesion with extension across the mid-line and * Corresponding author. Tel.: +1-806-7433155; fax: + 1-8067433148. E-mail address: [email protected] (R.C. Kimbrough III).
evidence of transtentorial herniation. She was immediately intubated and treated with diuretics and broad spectrum antibiotics. She was transferred to a tertiary care center for neurosurgical evaluation. Aspiration of the lesion through a precoronal burr hole yielded 35 ml of purulent necrotic material. A drain was left in place. Cultures of the material grew Salmonella enteritidis. Ceftazidime, which had been initiated the day of her transfer was continued based upon sensitivities. Blood, urine, and stool cultures were negative. The patient’s level of consciousness improved and she was extubated, however, 48 h later she deteriorated. Repeated CT scan demonstrated persistent mass effect and edema. The possibility of an underlying neoplasm was entertained. The patient underwent left frontal craniotomy and a large amount of purulent material was drained. Cultures from this material were negative. The abscess cavity was irrigated and barbotaged thoroughly with antibiotic solution. The craniotomy was tolerated well, however, clinical improvement was not seen. Repeated CT scan continued to demonstrate a mass lesion with little change in size. Lack of appropriate response to 6 weeks of ceftazidime prompted a second craniotomy with biopsy which confirmed the diagnosis of glioblastoma multiforme. Antineoplasic therapy was not given in view of the patient’s poor condition. She went into respiratory arrest and expired 52 days after her transfer. An autopsy was not performed.
0303-8467/00/$ - see front matter © 2102 Elsevier Science B.V. All rights reserved. PII: S 0 3 0 3 - 8 4 6 7 ( 0 0 ) 0 0 0 9 9 - 8
3 weeks/M
28 years/M
47 years/M
78 years/M
49 years/F
24 years/M
59 years/M
8 months/M
43 years/M
4 weeks/F
58 years/F
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
PR
Character/location
Clinical manifestations
Single/temporal
Single/parietal
Glioblastoma multiforme
IgA and IgG1 subclass deficiency, bacteremia, meningitis
Bacteremia, meningitis
Gastroenteritis
Single/frontal
Multiple/bifrontal
Single/parietal
Single/left hemisphere
Ampicillin/4 weeks, chloramphenicol/4 weeks
Cefotaxime/8 weeks, chloramphenicol/3 weeks, ciprofloxacin/5 weeks Chloramphenicol/6 weeks, TMP-SMZ/6 weeks
Antimicrobial regimenb/duration
Penicillin/2 weeks, streptomycin/2 weeks, chloramphenicol/4 weeks Fever, confusion, headache Cefotaxime/3 weeks, oral ciprofloxacin/4 months Fever, irritability, signs of Cefotaxime/9 weeks, raised intracranial pressure, ciprofloxacin/10 weeks, hydrocephalus ampicillin/5 weeks, chloramphenicol/2 weeks, metronidazole/2 weeks Fever, decreased sensorium, Ceftazidime/6 weeks hemiparesis, III cranial nerve palsy
Fever, restlessness, bulging fontanelles, tremors
Cefotaxime/2 days, ampicillin/2 days, amikacin/2 days Sepsis, decreased sensorium Cefotaxime/3 weeks, gentamycin/1 week, ceftazidime/6 weeks Fever, decreased sensorium, Ofloxacin/6 days, VI cranial nerve palsy cefotaxime/6 days, ceftazidimec, amikacinc, ciprofloxacinc Fever, neck mass Cefotaximec, metronidazolec
Multiple/occipital and Septic shock, decreased biventricular sensorium, seizures
Diabetes mellitus, Multiple/frontal and gallbladder adenoCA, temporal cholelithiasis, gastroenteritis
Glioblastoma multiforme, steroid therapy, bacteremia, meningitis Excision brain astrocytoma, steroid therapy, bacteremia, meningitis Excision glioblastoma multiforme, steroid therapy, bacteremia, meningitis
Subarachnoidal Multiple/bifrontal and Fever, seizures, jaundice hemorrhage, gastroenteritis, occipital bacteremia, meningitis Excision metastatic brain Single/occipital Fever, headache, vomiting, tumor, bacteremia papilledema, quadrantanopsia AIDS, IVDA, Single/frontal Fever, headache, decreased gastroenteritis, bacteremia, sensorium meningitis
Associated conditions
Yes
Yes
No
Yes
No
Yes
Yes
No
No
Yes
Yes
Surgical drainage
Died
Recovered/2 years
Recovered/6 months
Recovered after excision concurrent mycotic aneurysm carotid artery/6 months Recovered/2 years
Recovered/NS
Residual hemiparesis/NS
Relapsed, treated with ampicilin, TMP-SMZ and drainage/died 7 weeks later of pneumonitis Died
Recovered/NS
Recovered, slightly delayed development/2 years
Outcome/length of follow-up
b
Abbreviations: AIDS, acquired immunodeficiency syndrome; IVDA, intravenous drug abuse; TMP-SMZ, trimetroprim-sulfamethoxazole; NS, not stated; PR, present report. Given intravenously unless otherwise specified. c Duration of treatment not provided.
a
Age/sex
Reference
Table 1 Clinical characteristics of 11 patients with S. enteritidis brain abscessa
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239 237
238
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239
3. Discussion Intracranial infections are unusual manifestations of salmonellosis and brain abscess caused by S. enteritidis is particularly rare. We reviewed the worldwide medical literature by the use of MEDLINE back to 1966 and the references of retrieved articles, and found reports of ten patients with brain abscess caused this organism [3 – 12]. The clinical characteristics of these cases and our case are outlined in Table 1. A variety of predisposing factors have been described in patients with Salmonella intracranial infections [3– 5]. These include primary or metastatic brain tumors, subarachnoid hemorrhage, neurosurgical procedures, steroid use, diabetes mellitus, immunoglobulin deficiencies, and HIV infection. The location of the abscess and the clinical features of these patients did not differ from those with brain abscess caused by other organisms. Fulminant presentations [6] and relapses [5,7] occurred. Of the 11 cases described here, only four had antecedent gastroenteritis caused by S. enteritidis, eight were bacteremic, and seven had meningitis (Table 1). Because a history of gastroenteritis with positive stool cultures for S. enteritidis is not uniformly present and cerebrospinal fluid (CSF) analysis, if obtained, may be normal, the diagnosis is often unsuspected or delayed. Early neuroimaging studies and in some cases diagnostic aspiration of the abscess fluid are required to make a prompt diagnosis. Lumbar puncture is nondiagnostic and is contraindicated [13]. The use of an adequate antimicrobial regimen combined with early surgical drainage will result in the best probability for cure [3,4,7,8,12]. The choice of antibiotics is complicated by the increasing prevalence of resistance among Salmonella spp. to ampicillin, trimetroprim-sulfamethoxazole, chloramphenicol, thirdgeneration cephalosporins, and fluoroquinolones [14– 16]. Furthermore, strains resistant to multiple agents have been reported [16,17]. Third-generation cephalosporins are the most consistently used agents to treat central nervous system (CNS) infections caused by Salmonella spp. Chloramphenicol should be considered a reasonable alternative since it exhibits excellent in vitro activity against most Salmonella strains and penetrates the CSF well, however, an overstated fear of toxicity has limited its more widespread use [4]. Aminoglycosides are clinically ineffective despite their in vitro activity, perhaps because their poor CNS penetration and lack of activity against intracellular Salmonella. Fluoroquinolones are highly active against most Salmonella strains and penetrate the CSF well. Levels of ciprofloxacin in the CSF are usually well above the MIC for most Salmonella spp. [18]. Although clinical data is still limited [3,11,12,18 – 21] these agents should be considered good alternatives in infections caused by
strains resistant to other antimicrobials. Ultimately, agents with little demonstrated resistance and adequate CNS penetration should be selected to treat these complicated infections, and courses of at least 6 weeks are indicated to prevent relapses [7]. Mortality rates of 40–60% are reported for patients with intracranial infections caused by Salmonella spp., and a significant number of survivors develop permanent neurologic sequelae [2,22]. Of the 11 patients described here, nine survived and six recovered without neurologic deficits. These more favorable results probably reflect the fact that most of these patients received prompt antimicrobial and surgical treatment. A less favorable outcome is obtained when a co-morbid condition such as an intracranial neoplasm or HIV infection is present. References [1] Hogue A, White P, Guard-Petter J, et al. Epidemiology and control of egg-associated Salmonella enteritidis in the United States of America. Rev Sci Tech 1997;16:542 – 53. [2] Cohen JI, Barlett JA, Corey RG. Extraintestinal manifestations of Salmonella infection. Medicine 1987;66:349 – 88. [3] Wessalowski R, Thomas L, Kivit J, Voit T. Multiple brain abscesses caused by Salmonella enteritidis in a neonate: successful treatment with ciprofloxacin. Pediatr Infect Dis J 1993;12:633 – 8. [4] Rodriguez RE, Valero V, Watanakunakorn C. Salmonella focal intracranial infections: review of the world literature (1884– 1984) and report of an unusual case. Rev Infect Dis 1986;8:31– 41. [5] Fraimow HS, Wormser GP, Coburn KD, Small CB. Salmonella meningitis and infection with HIV. AIDS 1990;4:1271 –3. [6] Noguerado A, Cabanyes J, Vivancos J, et al. Abscess caused by Salmonella enteritidis within a glioblastoma multiforme. J Infect 1987;15:61 – 3. [7] Fiteni I, Ruiz FJ, Crusells MJ, Sanjoaquin I, Guillen G. Infection multifocale du systeme nerveux central a Salmonella enteritidis: efficacite des nouvelles cephalosporines. Presse Med 1995;24:309 – 11. [8] Bossi Ph, Mion G, Brinquin L, Bonsignour JP. Abces cerebral postoperatoire a Salmonella enteritidis. Presse Med 1993;22:130. [9] Lloret MD, Escudero JR, Hospedales J, Viver E. Mycotic aneurysm of the carotid artery due to Salmonella enteritidis associated with multiple brain abscesses. Eur J Vasc Endovasc Surg 1996;12:250 – 2. [10] Brzezinski J, Planeta-Malecka I, Zierski J, Bielinska W. Ropien mozgu w przebiegu zakazenia paleczka Salmonella enteritidis 8-miesiecznego dziecka. Pediatr Pol 1969;44:223 – 6. [11] Bonvin P, Ejlertsen T, Dons-Jensen H. Brain abscess caused by Salmonella enteritidis in an immunocompetent adult patient: successful treatment with cefotaxime and ciprofloxacin. Scand J Infect Dis 1998;30:632 – 4. [12] Workman MR, Price EH, Bullock P. Salmonella meningitis and multiple cerebral abscesses in an infant. Int J Antimicrob Agents 1999;13:131 – 2. [13] Chun CH, Johnson JD, Hofstetter M, Raff MJ. Brain abscess. A study of 45 consecutive cases. Medicine (Baltimore) 1986;65:415 – 31. [14] Herikstad H, Hayes PS, Hogan J, Floyd P, Snyder L, Angulo FJ. Ceftriaxone-resistant Salmonella in the United States. Pediatr Infect Dis J 1997;16:904 – 5.
J.C. Sarria et al. / Clinical Neurology and Neurosurgery 102 (2000) 236–239 [15] Herikstad H, Hayes P, Mokhtar M, Fracaro ML, Threlfall EJ, Angulo FJ. Emerging quinolone-resistant Salmonella in the United States. Emerg Infect Dis 1997;3:371–2. [16] Lee LA, Puhr ND, Maloney EK, Bean NH, Tauxe RV. Increase in antimicrobial-resistant Salmonella infections in the United States, 1989 – 1990. J Infect Dis 1994;170:128–34. [17] Cherubin CE. Antibiotic resistance to Salmonella in Europe and the United States. Rev Infect Dis 1981;3:1105–26. [18] Scheld WM. Quinolone therapy for infections of the central nervous system. Rev Infect Dis 1989;11(Suppl. 5):S1194– 202. [19] Bhutta ZA, Farooqui BJ, Sturm AW. Eradication of a multiple drug resistant Salmonella paratyphi A causing meningitis with
.
239
ciprofloxacin. J Infect 1992;25:215 – 9. [20] Ragunathan PL, Potkins DV, Watson JG, Kearns AM, Carroll A. Neonatal meningitis due to Salmonella typhimurium treated with ciprofloxacin. J Antimicrob Chemother 1990;26:727–8. [21] Visudhiphan P, Chiemchanya S, Visutibhan A. Salmonella meningitis in Thai infants: clinical case reports. Trans R Soc Trop Med Hyg 1998;92:181 – 4. [22] Kinsella TR, Yogey R, Shulman ST, Gilmore R, Chadwick EG. Treatment of Salmonella meningitis and brain abscess with the new cephalosporins: two case reports and review of the literature. Pediatr Infect Dis J 1987;6:476 – 80.