Salmonella brain abscess in an infant

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Figure 1
Computed tomography (CT) scan of the brain showed a large, 6x4x3.7 cm hypodense area likely extra axial location in the right high posterior parietal region with enhancing wall suggestive of empyema/abscess with mass effect and displacement and compression of ipsilateral right frontal horn and mild dilatation of left frontal and right temporal horn of lateral ventricle and midline shift to the left by 8-9mm. There is reduced density of a large area of the underlying right posterior frontal and parietal brain regions, likely edema.
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Figure 2
Computed tomography (CT) was repeated 2 weeks post operation.

Table 1

Summarizes the patient progress on a timely manner from the day of admission until discharged.

Date	Relevant past medical history and interventions
3rd August 2014	A 3-month old baby boy, born at term via spontaneous vaginal delivery for prim mother who had no antenatal risk for neonatal sepsis, had good APGAR score and no SCBU admission. Admitted in August with Salmonella species bacteremia complicated with meningitis evident clinically and radiologically, treated sub optimally with ceftriaxone for 14 days then discharged home.

Dates	Summaries from initial and follow-up visits	Diagnostic testing	Interventions
3rd November 2014	Readmitted with a history of 2 weeks fever (>= 38c) associated with 2 episodes of focal tonic-clonic convulsions. Later developed 2 episodes of left-sided focal tonic-clonic convulsions of 2 minutes’ duration. This febrile illness was preceded by a history of diarrhea of one day with no other household member had diarrheal illness during that period. After discharge from this admission patient lost follow up with our health care	Blood culture was negative CT brain: showed features suggestive of right high posterior parietal region empyema/abscess with edema and mass effect	Tapping of the abscess through burr hole
4^th November 2014		Pus culture grew Salmonella L species
from 5th November to 21st November 2014			Ceftriaxone (50 mg/kg - 12 hourly)

APGAR - Activity, Pulse, Grimace, Appearance, Respiration, SCBU - Special Care Baby Unit