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Case Reports in Infectious Diseases
Volume 2017 (2017), Article ID 1051975, 3 pages
https://doi.org/10.1155/2017/1051975
Case Report

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

1Division of Pharmaceutical Sciences, University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
2Madison Emergency Physicians, Madison, WI, USA
3Division of Infectious Disease, Department of Internal Medicine, SSM Health Dean Medical Group, Madison, WI, USA
4Division of Infectious Disease, Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
5Department of Emergency Medicine, SSM Health St. Clare Hospital, Baraboo, WI, USA
6Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Correspondence should be addressed to Matthew P. Lazio; moc.snaicisyhpycnegremenosidam@oizal

Received 24 April 2017; Accepted 12 July 2017; Published 14 August 2017

Academic Editor: Raul Colodner

Copyright © 2017 Andrew C. Elton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.