Forty-one pediatric cases of non-typhoidal salmonellosis

Non-typhoidal Salmonella (NTS) infections are a major cause of infantile death in developing countries. OBJECTIVE: The aim of this study was to determine the epidemiologic and therapeutic data, as well as the evolution of NTS in Morocco. METHOD: This retrospective study was made on 41 patients hospitalized for NTS between 1994 and 2002 in the Casablanca University Hospital Pediatric ward. RESULTS: Twenty cases of digestive salmonellosis were diagnosed, 16 cases of septicemia, and 10 cases of meningitis. Ten patients were hospitalized after an outbreak of resistant Salmonella typhimurium in a nursery. Fifty percent of the patients were less than 3 months of age. The three patients between 1 and 3 years of age presented with primary immunodeficiency. Fever, vomiting, and diarrhea were noted in 97% of the cases. The stools were watery in 89% and severe dehydration in 55% of the cases. Salmonella strains were identified in blood in 25 cases, from stools in 10 cases, and from CSF in nine cases. The following Salmonella serotypes were identified: S. typhimurium (53.6%), S. enteritidis (44%), and S. agona (2.4%). Resistance to antibiotics was noted, especially for Salmonella typhimurium (34%) in the nursery outbreak. The evolution was favorable in 80%, but two children with meningitis developed severe neurological sequels, and six hypotrophic infants under 3 years of age died after septicemia.