Salmonella enterica serovar Panama meningitis in exclusive breastfeeding infants

RATIONALE The pathway of Nontyphoid Salmonella meningitis, especially in exclusive breastfeeding infants, has not been well characterized. PATIENT CONCERNS We analyzed data related to nontyphoid Salmonella meningitis in 4 infants. DIAGNOSES No diarrhea was observed and the coproculture was negative for all patients. INTERVENTIONS Early diagnosis and treatment with combination of third-generation cephalosporins plus quinolones for a minimum of 3 weeks is necessary to avoid severe sequelae and death. OUTCOMES The first 3 patients had a good evolution, whereas the last patient had multiple brain abscesses and hydrocephalus requiring treatment with a ventriculoperitoneal shunt. LESSONS The highlights of our study are that all infants were exclusively breastfed, no diarrhea observed and the negative coproculture for all the 4 patients, which is relatively rare for Salmonella infection.