# Recurrent meningitis due to Salmonella arizonae in an adult with AIDS: case presentation and next-generation sequencing analysis

## TL;DR

A man with AIDS experienced multiple meningitis episodes caused by Salmonella arizonae, a rare infection typically linked to reptiles.

## Contribution

This is the first reported case of recurrent meningitis due to S. arizonae in an adult with AIDS, confirmed using next-generation sequencing.

## Key findings

- An adult with HIV had five episodes of meningitis caused by Salmonella arizonae over 8 months.
- Genomic analysis confirmed antibiotic sensitivity and identified the pathogen via next-generation sequencing.
- The patient improved after surgery, antiretroviral therapy, and prolonged antibiotics.

## Abstract

Invasive non-typhoidal Salmonella disease is a leading cause of morbidity and mortality worldwide, primarily affecting children, the elderly, and immunocompromised adults, particularly those living with HIV. Salmonella meningitis is rare, except in sub-Saharan Africa. Salmonella arizonae is associated with reptiles and exceptionally causes meningitis in humans.

We present the case of an adult man living with HIV who presented five episodes of bacterial meningitis due to S. arizonae within a period of 8 months. The patient improved after performing cholecystectomy and with optimization of antiretroviral treatment and prolonged antibiotic therapy. Genomic study confirmed that S. arizonae is sensitive to antibiotics.

This case illustrates a rare form of S. arizonae meningitis. The identity of the etiological agent was confirmed by next-generation sequencing analysis.