DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181486

Atypical form of early neonatal infection with Salmonella enterica: case report with literature review

Zafitsara Z. Andrianirina, Rosa L. Tsifiregna, Romuald Randriamahavonjy, J. Bizet

Abstract


Salmonella are rarely responsible for neonatal or perinatal infection. An annual incidence of 75/100000 births are reported in the USA. The authors present a case of a newborn with neonatal salmonellosis in the context of maternal infection in the days preceding the birth, documented retrospectively. This is a case of a 38-week male infant born via spontaneous vaginal delivery. There was a premature rupture of the membranes (13 hours). The mother gave a history of fever and diarrhea of ten days prior to delivery. She had fever of 38.3°C during labor. Prophylactic antibiotic treatment with amoxicillin was established. Thirty-two hours after birth, the baby developed fever, lethargy, and was not accepting feeds. On admission, physical examination showed fever, tachycardia, correct blood pressure and isolated jaundice. The blood count found a leukopenia, a thrombocytopenia, a CRP at 35mg/l. Parenteral antibiotic therapy with cefotaxime and amikacin was started. Apyrexia is obtained after 48 hours of intravenous treatment. Stool culture of the newborn grew after 48 hours and for the mother after 3 days. The germ identified was Salmonella enterica Serovar 4,5,12:i:-. Blood cultures were performed on the mothers and the baby, but the cultures were negative. The baby responded and was discharged on the 15th day of delivery. The mother’s condition was complicated by a Guillan Barré syndrome that required a transfer to neurology. Neonatal salmonellosis may have non-specific clinical symptoms. Management is based on early antibiotic therapy with a third-generation cephalosporin as first-line therapy. The measure in preventing the spread of infection in the neonatology is essential to avoid secondary cases.


Keywords


Antibiotics, Infections, Newborn, Salmonella, Stool and blood culture

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References


Wings ES, Troppoli DV. The intra-uterine transmission of typhoid. JAMA. 1930;95:405-6.

Guerrant RL, Cleary TG, Pickering LK. Microorganisms responsible for neonatal diarrhea. In: Infectious Diseases of the Fetus and Newborn Infant. Eds.Remington JS, Klein JO Philadelphia, W.B. Saunders Co;1990:920-6.

Roll C, Schmid NE, Menken U, Hanssler L. Fatal Salmonella Enteritidis sepsis acquired prenatally in a premature infant. Obstet Gynecol. 1996;88:692-3.

Ido N, Lee KI, Iwabuchi K, Izumiya H, Uchida I, Kusumoto M, et al. Characteristics of Salmonella enterica serovar 4,[5], 12: i:-as a monophasic variant of serovar Typhimurium. PLoS One. 2014;9(8):e104380.

Mohanty S, Gaind R, Sehgal R, Chellani H, Deb M. Neonatal sepsis due to Salmonella Typhi and Paratyphi A. J Infection Developing Countries. 2009;3(08):633-8.

Lee MB, Greig JD. A review of nosocomial Salmonella outbreaks: infection control interventions found effective. Public Health. 2013;127:199-206.

Prince M, Boye CF, Boup MS. Investigation of an epidemic of Salmonellosis in a neonatology unit in the tropics. Med Mal Inf. 1987;3:124-7.

Carles G, Montoya Y, Seve B, Rakotofananina T, Largeaud M, Mignot V. Typhoid fever and pregnancy. J Gynecol Obstet Biol Reprod. 2002;31:495-9.

Watson KC. Intravascular Salmonella typhi as a manifestation of the carrier state. Lancet. 1967;290:332-4.

Chin KC, Simmonds EJ, Tarlow MJ. Neonatal typhoid fever. Arch Dis Child. 1986;61:1228-30.

Cooke FJ, Ginwalla S, Hampton MD, Wain J, Ross-Russell, Lever A, et al. Report of neonatal meningitis due to salmonella enterica serotype agona and review of breast milk-associate neonatal salmonella infections. J Clin Microbiol. 2009;47(9):3045-49.

Drhova A, Dobiasova V, Stefkovicova M. Mother's milk unusual factor of infection in a salmonellosis epidemic newborn ward. J Hyg Epidemiol Microbiol Immunol. 1990;34:353-5.

Gibb AP, Welsby PD. Infantile salmonella gastroenteritis in association with maternal mastitis. J Infect. 1983;6:193-4.

Fleischrocker G, Vutuc C, Werner HP. Infection of a newborn Infant by breast milk containing Salmonella typhimurium. Wien Klin Wochenschr. 1972;84:394-5.

Maroszynska I, Piestrzeniewicz KF, Niedzwiecka M. Salmonella typhimurium-A threat for a newborn. OJOG. 2013;3:628-30.

Kayemba S, Raobijaona H, Francois P, Croize J, Bost-Bru C. Acute meningitis with Salmonella Typhi in a 25-day-old newborn complicated by obstruction of the Sylvian artery. Arch Pediatr. 2000;7:154-7.

Chhabra R, Glaser J salmonella infection presenting as hematochezia on the first day of life. J Pediatr. 1995;7:65-7.

Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL. Typhoid fever. Lancet. 2015;385:1136-45.

Vilca LM, Bartolomé R, Arquer MD, Albero I, Ribes C, Campins-Marti M. Mother as a vector of Salmonella enterica serotype Newport outbreak in a neonat unit. Enferm Infecc Microbiol Clin. 2015;33:536-8.

Ault KA, Kennedy M, Seoud MAF, Reiss R. Maternal and neonatal infection with Salmonella Heidelberg: A case report. Infect Dis Obstet Gynecol. 1993;1:46-8.