Intracranial infection and sepsis in infants caused by Salmonella derby: A case report

BACKGROUND: Salmonella derby (S. derby) is a Gram-negative diplococcus that is common in the digestive tract. Infected patients generally experience symptoms such as fever and diarrhea. Mild cases are mostly self-healing gastroenteritis, and severe cases can cause fatal typhoid fever. Clinical cases are more common in children. The most common form of S. derby infection is self-healing gastroenteritis, in which, fever lasts for about 2 d and diarrhea for < 7 d. S. derby can often cause bacterial conjunctivitis, pneumonia, endocarditis, peritonitis and urethritis. However, intracranial infections in infants caused by S. derby are rare in clinical practice and have not been reported before in China. CASE SUMMARY: A 4-mo-old female infant had recurrent fever for 2 wk, with a maximum body temperature of around 39.4°C. Treatment for infectious fever in a local hospital was ineffective, and she was admitted to our hospital. Before admission, there was one sudden convulsion, characterized by unclear consciousness, limb twitching, gaze in both eyes, and slight cyanosis on the face. Cerebrospinal fluid (CSF) culture was positive for Gram-negative bacilli, which conformed to S. derby. After treatment with meropenem and ceftriaxone antibiotics, the patient was discharged home in a clinically stable state after 4 wk of treatment. CONCLUSION: We reported a rare case of S. derby cultured in CSF. S. derby enters the CSF through the blood–brain barrier, causing purulent meningitis. If not treated timeously, it can lead to serious, life-threatening infection.