Relapsed Nosocomial Neonatal Salmonella enterica sv. Typhi Meningitis: A Case Report

Salmonella enterica sv. Typhi (S typhi), the causative organism of enteric fever which is found mainly in the developing countries, is a severe systemic disease with a worldwide frequency estimated as 12-33 million cases per year. It is transmitted not only through contaminated food and beverages, but also via a vertical mechanism during the last trimester of pregnancy. Salmonella enterica sv. Typhi meningitis of the newborn is rare, but is important as its mortality, morbidity and relapse rates are high. The prognosis of salmonella meningitis is poor, even in the case of prompt diagnosis and adequate therapy. Third generation cephalosporines should be the first line drug of choice. However, cefotaxime used for 4 weeks could not prevent relapses. Meropeneme and ciprofloxacine could be used alternatively. We report a neonatal nosocomial S typhi meningitis case relapsing in spite of cefotaxime usage for 4 weeks, which was then treated with ciprofloxacine.