New Diagnosis of AIDS Based on Salmonella enterica subsp. I (enterica)‎ Enteritidis (A)‎ Meningitis in a Previously Immunocompetent Adult in the United States

Abstract EN

Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly.

This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions.

We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area.

He was febrile, tachycardic, and tachypneic with a GCS of 8.

The patient was intubated and a presumptive diagnosis of meningitis was made.

Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation.

A lumbar puncture showed cloudy CSF with Gram negative rods.

He was admitted to the ICU.

CSF culture confirmed Salmonella enterica subsp.

I (enterica) Enteritidis (A).

Based on this finding, a 4th-generation HIV antibody/p24 antigen test was sent.

When this returned positive, a CD4 count was obtained and showed 3 cells/mm3, confirming AIDS.

The patient ultimately received 38 days of ceftriaxone, was placed on elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (Genvoya) for HIV/AIDS, and was discharged neurologically intact after a 44-day admission.