Subgaleal and brain abscesses due to Salmonella enteritidis following craniotomy for giant cell glioblastoma multiforme: A case report and literature review

Abstract

Background: Cranial surgical site infections due to Salmonella species are rarely reported. Only eight cases of Salmonella enteritidis infection following intracranial surgery for brain tumor have been reported to date. We describe a unique case of both subgaleal and brain abscesses caused by S. enteritidis following craniotomy for a parafalcine giant cell glioblastoma multiforme. A literature review of the previously published cases is also provided. Case Description: A 36-year-old previously healthy man presented with a posterior parietal parafalcine giant cell glioblastoma multiforme. 5 weeks after craniotomy for tumor resection, the patient presented with worsening headache and painful swelling at the cranial operative site. Head computed tomography and magnetic resonance imaging scans revealed both scalp and brain abscesses in the previous surgical site. He was treated with aspiration of the subgaleal abscess and ciprofloxacin antibiotic therapy; he made a full recovery. Cultures of the aspirate identified S. enteritidis, although the primary site of infection was not detected. Conclusions: Although postoperative S. enteritidis infections are rare, the large numbers of patients with malignant brain tumors who require tumor resections and receive corticosteroids are at great risk. Adequate drainage (if possible), early isolation of the pathogens, and control of the infection by antibiotic therapy guided by antimicrobial susceptibility testing are vital components to prevent this potentially fatal condition.