NONTYPHOIDAL SALMONELLA INTRACRANIAL INFECTIONS IN HIV-INFECTED PATIENTS

Salmonella focal intracranial infections are unusual in human immunode ficiency virus (HIV)-infected patients. Six such infections have been reported in the world literature. We report a case of salmonella subdu ral and epidural cerebral empyema with concomitant osteomyelitis of th e frontal bone. Such a complication in the course of salmonellosis is reported for the first time. In previously published case reports, fou r patients had brain abscess and two had subdural empyema. Salmonella typhimurium was isolated from two patients, and different serotypes we re recovered from the others. All patients had advanced HIV disease, a nd all but two had had opportunistic infections before the diagnosis o f salmonella intracranial infection. Surgical drainage combined with s ystemic antibiotic therapy resulted in the recovery of four of five pa tients. No regression of the lesions occurred in one patient treated o nly with antibiotics for multiple cerebral abscesses.