Acute encephalopathy associated with nontyphoidal salmonellosis

The importance of an acute encephalopathy associated with nontyphoidal salm onellosis has recently been recognized, but the disease entity has been poo rly established. In this study, we describe two encephalopathic patients as sociated with nontyphoidal salmonellosis. The patients exhibited a rapid ev olution of coma after the onset of lethargy or seizure. Fever and diarrhea due to salmonellosis preceded these events. Secondary factors inducing ence phalopathies, such as severe dehydration, sepsis, meningitis, electrolyte o r metabolic disturbances, acute renal failure, and multiple organ failure, were excluded in the differential diagnosis at the onset of encephalopathic features. These clinical findings and rapid development of encephalopathic features from localized intestinal infection without any significant abnor malities in a variety of blood tests may suggest a toxic etiology. However, endotoxin was not found in serum from both patients. From these results, w e conclude that nontyphoidal salmonellosis can cause a toxic encephalopathy syndrome, like shigellosis or verocytotoxin-producing Escherichia coli inf ection.