title: Salmonella enterica serovar Enteritidis brain abscess mimicking meningitis after surgery for glioblastoma multiforme: a case report and review of the literature.
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 by Salmonella enterica serovar Enteritidis mimicking post-surgical meningitis in a patient with glioblastoma multiforme.
  
  
  METHODS
  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 for S. 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 same S. enterica Enteritidis isolate. She recovered and was discharged 6 weeks after admission.
  
  
  CONCLUSIONS
  In this case report, a brain abscess was initially diagnosed as Salmonella post-surgical meningitis before the imaging diagnosis of the brain abscess. The diagnosis of brain abscess should be considered in all cases of non-typhoidal Salmonella meningitis after surgery for brain tumor. Surgical brain abscess drainage followed by prolonged antibiotic treatment remains a major therapeutic option.
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.|Pôle de Maladies Infectieuses, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France.
authors.forename: Léa
authors.initials: L
authors.lastname: Luciani
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.|Pôle de Maladies Infectieuses, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Dubourg
authors.affiliation: Service de neurochirurgie, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, 13005, Marseille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Graillon
authors.affiliation: Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005, Marseille, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Honnorat
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Lepidi
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.|Pôle de Maladies Infectieuses, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France. sengpiseth@yahoo.fr.|Pôle de Maladies Infectieuses, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France. sengpiseth@yahoo.fr.|Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005, Marseille, France. sengpiseth@yahoo.fr.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine, Aix Marseille Université, 27, Boulevard Jean Moulin, 13385, Marseille, Cedex 5, France. sengpiseth@yahoo.fr.
authors.forename: Piseth
authors.identifier: http://orcid.org/0000-0002-0300-2728
authors.initials: P
authors.lastname: Seng
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005, Marseille, France.|Pôle de Maladies Infectieuses, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, 13005, Marseille, France.|Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005, Marseille, France.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
mesh_terms: D001922:Brain Abscess / Q000382:microbiology*; D001932:Brain Neoplasms / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D016920:Meningitis, Bacterial; D008875:Middle Aged; D012480:Salmonella Infections / Q000150:complications*; D012477:Salmonella enteritidis
keywords: Bacteria; Brain abscess; Glioblastoma; Human; Infection; MALDI-TOF; Post-surgery meningitis; Salmonella; Salmonella enterica