Salmonella entericaserovarEnteritidis brain abscess mimicking meningitis after surgery for glioblastoma multiforme: a case report and review of the literature. (December 2016)

• Record Type: Journal Article
• Authors: Luciani, Léa; Dubourg, Grégory; Graillon, Thomas; Honnorat, Estelle; Lepidi, Hubert; Drancourt, Michel; Seng, Piseth; Stein, Andreas
• Is Part Of: Journal of medical case reports. Volume 10:Number 1(2016)
• Page Start: 1
• Page End: 5
• Publication Date: 2016-12
• Subjects: Brain abscess -- Glioblastoma -- Post-surgery meningitis -- Salmonella -- Salmonella enterica -- MALDI-TOF -- Bacteria -- Infection -- Human; Medicine -- Research -- Periodicals; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1186/s13256-016-0973-9
• Languages: English
• ISSNs: 1752-1947

Abstract

Abstract Background Salmonella brain abscess associated with brain tumor is rare. Only 11 cases have been reported to date. Here we report a case of brain abscess caused bySalmonella enterica serovar Enteritidis mimicking post-surgical meningitis in a patient with glioblastoma multiforme. Case presentation A 60-year-old Algerian woman was admitted through an emergency department for a 4-day history of headache, nausea and vomiting, and behavioral disorders. Surgery for cerebral tumor excision was performed and histopathological analysis revealed glioblastoma multiforme. On the seventh day post-surgery, she presented a sudden neurological deterioration with a meningeal syndrome, confusion, and fever of 39.8°C. Her cerebrospinal fluid sample and blood cultures were positive forS. enterica Enteritidis. She was treated with ceftriaxone and ciprofloxacin. On the 17th day post-surgery, she presented a new neurological disorder and purulent discharge from the surgical wound. Brain computed tomography revealed a large cerebral abscess located at the operative site. Surgical drainage of the abscess was performed and microbial cultures of surgical deep samples were positive for the sameS. enterica Enteritidis isolate. She recovered and was discharged 6 weeks after admission. Conclusions In this case report, a brain abscess was initially diagnosed asSalmonella post-surgical meningitis before the imaging diagnosis of the brain abscess. The diagnosis of brain abscess should be considered in all cases of non-typhoidalSalmonella meningitis after surgery for brain tumor. Surgical brain abscess drainage followed by prolonged antibiotic treatment remains a major therapeutic option.