Purulent meningitis caused by salmonella group D in a one-year-old child: lessons learned from mistakes

Salmonella infection-induced meningitis and sepsis are prone to recurrence. If not diagnosed and treated in time in the early stage or if the treatment is not thorough, it may cause serious consequences for the child. Reports of cases of sepsis and purulent meningitis in children caused by Salmonella infection are very rare. This article reports a case of purulent meningitis combined with sepsis caused by Salmonella group D. It describes the repeated clinical manifestations and treatment process of the child, and analyzes it in combination with the literature. The child was a 1-year-and-1-month-old girl. The disease course was recurrent, and she was hospitalized 3 times. Initially, due to insufficient anti-infection treatment, the condition recurred. Later, through cerebrospinal fluid metagenomic sequencing (mNGS) and pathogen culture, it was confirmed as Salmonella group D infection, and the diagnosis was confirmed by combining the H/O antibody titer (1:320) of the widal test. During the treatment process, ceftriaxone, vancomycin, meropenem, and compound sulfamethoxazole were used successively. Finally, the condition was controlled by extending the anti-infection treatment course and combining with immune support. This case suggests that invasive Salmonella infections should be given attention to drug resistance assessment, adequate anti-infection treatment courses, and monitoring of immune status. Clinically, molecular diagnostic techniques such as mNGS should be combined to accurately identify the pathogen, and the treatment plan should be dynamically adjusted to improve prognosis and reduce the risk of recurrence.