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Editor,—Salmonellosis associated with reptiles is well documented1-3 but a proved link between salmonella meningitis and reptilian carriage has not been reported.
Salmonella uzaramo was isolated from the cerebrospinal fluid, blood, and stool cultures of a 5 month old white boy, admitted with symptoms, signs, and typical findings of bacterial meningitis. Treatment with cefotaxime 200 mg/kg daily for three weeks appeared to provide a rapid clinical response but the child was readmitted three days after discharge with vomiting and irritability.S uzaramo was reisolated from the cerebrospinal fluid. Ciprofloxacin was added to cefotaxime and this time the infection was successfully eradicated, the child being discharged after a further three weeks with normal cerebrospinal fluid and no apparent neurological deficit.
The family owned three snakes: an Indian python and two Royal pythons, which lived in two separate tanks in the dining room. The Indian python was frequently handled and roamed freely around the house. Faeces samples from the Indian python grew S uzaramo; faeces from the Royal pythons grew S uzaramo, S arizonae,S lome and an unnamed salmonella species. None of the family members had suffered significant diarrhoeal episodes and stool samples were negative.
Import regulations on reptiles have been significantly eased in recent years and a large market in reptile purchase and exchange exists in the UK. Most reptile owners are probably unaware of the likelihood of salmonella carriage in their pets, even though carriage of salmonella species in reptiles is almost universal (as high as 94%).4 Adequate information is not provided to the potential purchaser on possible health risks and the importance of hand washing: young children are at particular risk of serious infection, the majority of salmonella meningitis cases occurring in patients under 1 year. Investigators of cases of salmonella infection should be aware of the possible significance of reptiles or exotic pets and liaise with local microbiology departments; faeces samples can be obtained relatively easily from lizards and snakes.
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