Nontyphoidal Salmonella encephalopathy in a teenager from Hubei, China

Nontyphoidal <i>Salmonella</i> (NTS) encephalopathy is rare, especially without gastroenteritis. We report a case in a healthy 14-year-old girl presenting with rash and headache, but no diarrhea. Cerebrospinal fluid culture grew Gram-negative bacilli. Genomic sequencing identified a multidrug-resistant <i>Salmonella</i> Typhimurium ST36 strain. The patient progressed to subarachnoid hemorrhage. This case highlights that invasive NTS disease can present atypically in adolescents. NTS should be considered in encephalopathy differentials, irrespective of intestinal symptoms.