Aim There are over 2500 strains of salmonella species which is a notifiable bacteria in the UK. It is one of the four most common worldwide diarrhoeal diseases. Salmonella meningitis is a rare complication, with less 1% of bacterial meningitis being caused by salmonella in the developed world. We herein report a case of confirmed salmonella meningitis in 5-month-old baby with prolonged seizure who responded to appropriate antibiotic.

Material and Method The patient presented to the local hospital at five months of age with a history of coryzal symptoms, vomiting and a brief episode of generalised seizure. On examination they were irritable with neck stiffness and bulging fontanelle. The child subsequently developed focal seizure which progressed into a prolonged generalised seizure that required phenytoin, phenobarbitone and rapid sequence induction requiring intubation and ventilation and admission to the Paediatric Intensive Care Unit.

Results Blood, urine, stool, and CSF cultures grew salmonella species. The MRI Scan showed mild hydrocephalus with multiple small multiterritorial infarcts favoured sepsis aetiology, with a further MRI suggestive of pyogenic meningitis and ventriculitis. As advised by microbiology, the child was treated with IV ceftriaxone for one month and IV ciprofloxacin for three weeks. Seizure frequency improved gradually, and the child was discharged home. They are currently under MDT team for left sided hemiparesis and seizure.

Conclusions Salmonella meningitis is associated with high neurological morbidity especially in children under two years old. This case demonstrates the importance of early identification and management of meningitis and collaboration with microbiology for appropriate antibiotic coverage. Imaging such as MRI scans are useful for identifying neurological complications such as infarctions as in this case for early involvement with a multidisciplinary team for holistic management as well as enhanced visual and hearing tests.