SALMONELLA MENINGITIS IN THAI INFANTS - CLINICAL CASE-REPORTS

Between June 1988 and September 1996 12 of 65 infants (18%) admitted t o the Department of Pediatrics, Ramathibodi Hospital, Bangkok, Thailan d with purulent meningitis were infected with Salmonella spp. Their ag es ranged from 1.5 to 6 months. Six of the infants had diarrhoea, 9 ha d seizures, and II had subdural effusion or empyema. Six infants requi red surgical treatment; 2 had brain abscesses. Salmonella was recovere d from the cerebrospinal fluid of 11 infants and from the subdural flu id of 10. Eight infants were successfully treated with cefotaxime alon e or in combination with co-trimoxazole, one with co-trimoxazole, and one with the combination of co-trimoxazole and ampicillin. The duratio n of treatment was 6 weeks, except for one patient who had a large bra in abscess and was treated for 8 weeks. The last 2 patients, despite t he fact that the organisms were susceptible to cefotaxime, failed to r espond clinically to appropriate doses of it. Both were cured after ci profloxacin was added to the therapy. Ciprofloxacin is probably the dr ug of choice to be used in addition to the previously used antibiotics for severe cases of Salmonella meningitis in infants.