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Obscure manifestations of Salmonella subdural empyema in children: case report and literature review

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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.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatrics, Taichung Veterans General Hospital, No. 160, Sec. 3, Taichung-Kang Rd., Taichung, Taiwan, 40705

    Kai-Mao Chen, Hsiu-Fen Lee & Fang-Liang Huang

  2. Institute of Biochemistry and Biotechnology, College of Medicine, Chung-Shan Medical University, Taichung, Taiwan

    Hsiu-Fen Lee & Ching-Shiang Chi

  3. Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital, Taichung, Taiwan

    Ching-Shiang Chi

  4. Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan

    Cheng-Yi Chang

  5. Department of Radiology, Tungs’ Taichung Metroharbor Hospital, Taichung, Taiwan

    Hao-Chun Hung

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  1. Kai-Mao Chen
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Correspondence to Hsiu-Fen Lee.

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Chen, KM., Lee, HF., Chi, CS. et al. Obscure manifestations of Salmonella subdural empyema in children: case report and literature review. Childs Nerv Syst 27, 591–595 (2011). https://doi.org/10.1007/s00381-010-1274-z

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  • DOI: https://doi.org/10.1007/s00381-010-1274-z

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