A Case of Salmonella Meningitis in an Immunocompetent Infant

Salmonella species represent a documented, though rare, etiology of bacterial meningitis, predominantlyimpacting infants, elderly individuals, and those who are immunocompromised. The condition is associatedwith considerable morbidity and mortality, in addition to substantial neurological complications. A3-monthold male infant with no prior health issues was admitted to the emergency department at Jinnah Hospital,Lahore, presenting with a 48-hour history of fever, lethargy, poor feeding, and irritability. There was nosignificant travel history or known sick contacts, but the family had a pet bearded dragon at home. Onexamination, the infant was having fever (39.2°C), tachycardia, and had a bulging anterior fontanelle.Kernig's sign was negative. Initial laboratory investigations revealed leukocytosis with a left shift. Lumbarpuncture revealed CSF pleocytosis, high protein, and low glucose. Blood and CSF cultures were sent. Theinfant was empirically started on intravenous ceftriaxone and vancomycin. After 48 hours, both blood andCSF cultures grew Salmonella Enteritidis. Antibiotics were de-escalated to high-dose intravenousceftriaxone for a total course of 4 weeks. The patient showed gradual clinical improvement. This casehighlights the importance of considering non-typhoidal Salmonella as a causative agent of meningitis ininfants, even those who are apparently immunocompetent. Athorough history, including exposure to reptiles,is crucial. Salmonella meningitis requires prolonged antibiotic therapy and close monitoring forcomplications. This case had a positive outcome due to prompt diagnosis and appropriate management.