Year: 2026 | Month: May | Volume: 16 | Issue: 5 | Pages: 231-236
DOI: https://doi.org/10.52403/ijhsr.20260526
From Gut to Gray Matter: A Rare Brain Abscess Caused by Salmonella Typhi - A Case Report
Charmi Mangal1, Kejal Patel2, Nishita Padaria3, Rachana Solanki4, Kinal Shah5, Mahendra Vegad6
1Final Year Resident, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
2Senior Resident, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
3Assistant Professor, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
4Professor, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
5Professor and Head, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
6Professor, Department of Microbiology, Dr. M.K. Shah Medical College and Research Centre, Affiliated S.M.S. Multispecialty Hospital, Ahmedabad, Gujarat, India.
Corresponding Author: Dr. Charmi Mangal
ABSTRACT
Salmonella Typhi, a well-recognized cause of enteric fever in the Indian subcontinent, classically presents with bacteraemia and gastrointestinal manifestations. However, its capacity to produce extraintestinal abscesses at sterile sites such as the liver, spleen, bones, and central nervous system illustrates its remarkable invasive potential. We report an exceptionally rare case of S. Typhi brain abscess in an 18-year-old male who presented with progressive quadriparesis, altered sensorium, and focal neurological deficits. Magnetic resonance imaging (MRI) demonstrated a left fronto-temporo-parietal subdural abscess with a concurrent occipital intraparenchymal abscess, associated with surrounding oedema and mass effect. Craniotomy with surgical drainage was performed, and intraoperative pus cultures yielded S. Typhi, which was identified by conventional biochemical reactions and the VITEK® 2 Compact automated identification system. Serological tests further corroborated the findings. The isolate was susceptible to multiple first-line, second-line and reserve agents, including third-generation cephalosporins, with intermediate susceptibility to fluoroquinolones.
The patient exhibited marked clinical improvement with parallel radiological resolution following surgical drainage and prolonged intravenous ceftriaxone therapy. This case underscores the pathogenic versatility of S. Typhi to cause central nervous system abscesses, emphasizes the critical role of early radiological–microbiological correlation in the diagnosis of atypical intracranial abscesses, and reaffirms the therapeutic value of ceftriaxone in the current era of emerging antimicrobial resistance.
Key words: Brain Abscess; Central Nervous System Infections; Ceftriaxone; Extraintestinal Manifestations; Salmonella Typhi.