S Sirinavin1, S Chiemchanya, M Vorachit. 1. Division of Infectious Disease, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Abstract
BACKGROUND: The relative paucity of information about systemic nontyphoidal Salmonella (NTS) infection in infants without an underlying disease prompted this study. METHODS: Infants without an underlying disease, who had positive cultures for NTS from their normally sterile sites during 1978 through 1998, were included. Their medical records were reviewed. RESULTS: The study included 75 eligible infants; 68 (91%) had positive blood cultures. The spectrum of disease included transient bacteremia (5), bacteremia without localized infection (37), bone and joint infection (5) and meningitis (28); 53 and 88% of infants were < or =3 and < or =6 months old, respectively. All infants with localized infection were < or =7 months old, and infants with meningitis were 3.35+/-1.87 (mean +/- SD) months old. In bacteremic infants risks for localized infection and meningitis were 30 and 24%, respectively. Abnormal neurologic findings were the only predictor for meningitis. Relapse of meningitis occurred in two infants despite treatment with cefotaxime for 4 and 6 weeks. Severe neurologic deficit occurred in 21% of infants with meningitis. Of 11 infants with meningitis who received early treatment at this tertiary care center, 1 died but none had severe neurologic deficits; whereas of 17 referred cases, 2 died and 6 had severe neurologic abnormalities. No death occurred in infants without meningitis. CONCLUSION: Systemic NTS infection in normal infants has a variable disease spectrum. Infants 0 to 6 months of age are at high risk for localized infection, especially meningitis.
BACKGROUND: The relative paucity of information about systemic nontyphoidal Salmonella (NTS) infection in infants without an underlying disease prompted this study. METHODS:Infants without an underlying disease, who had positive cultures for NTS from their normally sterile sites during 1978 through 1998, were included. Their medical records were reviewed. RESULTS: The study included 75 eligible infants; 68 (91%) had positive blood cultures. The spectrum of disease included transient bacteremia (5), bacteremia without localized infection (37), bone and joint infection (5) and meningitis (28); 53 and 88% of infants were < or =3 and < or =6 months old, respectively. All infants with localized infection were < or =7 months old, and infants with meningitis were 3.35+/-1.87 (mean +/- SD) months old. In bacteremic infants risks for localized infection and meningitis were 30 and 24%, respectively. Abnormal neurologic findings were the only predictor for meningitis. Relapse of meningitis occurred in two infants despite treatment with cefotaxime for 4 and 6 weeks. Severe neurologic deficit occurred in 21% of infants with meningitis. Of 11 infants with meningitis who received early treatment at this tertiary care center, 1 died but none had severe neurologic deficits; whereas of 17 referred cases, 2 died and 6 had severe neurologic abnormalities. No death occurred in infants without meningitis. CONCLUSION: Systemic NTS infection in normal infants has a variable disease spectrum. Infants 0 to 6 months of age are at high risk for localized infection, especially meningitis.
Authors: Stephen M Graham; James Mwenechanya; Madalitso Tembo; Martha Kabudula; Elizabeth M Molyneux; Amanda L Walsh; Malcolm E Molyneux; Terrie E Taylor Journal: Malawi Med J Date: 2002-04 Impact factor: 0.875