Adolescent ; Empyema, Subdural ; etiology ; Female ; Humans ; Sinusitis ; complications ; Tomography, X-Ray Computed

Subdural empyema is fulminating purulent infection that develops between the dura and the arachnoid membranes. It is rare but one of the most immediate of neurosurgical emergencies, hence the importance of proper diagnosis and early intervention. Most subdural empyema complicated in the ENT field originate from sinonasal or otologic infections rather than dental infections. In our case of 64-years-old male, who was admitted with headache and fever, the diagnosed subdural empyema originated from odontogenic parapharyngeal abscess. We report that the case was successfully managed after urgent surgical drainage by endoscopic transethmoidal approach with long term intravenous antibiotics.
Abscess* ; Anti-Bacterial Agents ; Arachnoid ; Diagnosis ; Drainage* ; Early Intervention (Education) ; Emergencies ; Empyema, Subdural ; Fever ; Headache ; Humans ; Male ; Membranes

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M. tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.
Arm ; Contusions ; Craniotomy ; Emergency Service, Hospital ; Empyema ; Empyema, Subdural* ; Head ; Hemorrhage ; Humans ; Maxilla ; Middle Aged ; Mycobacterium tuberculosis ; Neurologic Examination ; Orbit ; Radius ; Ribs ; Scapula ; Seizures ; Skull Fractures* ; Skull* ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary ; Zygoma

Nontyphoidal Salmonella infection often results in acute gastroenteritis, but extraintestinal infection presenting as a subdural empyema is unusual. We report a case of a 67-year-old man diagnosed with a subdural empyema caused by Salmonella group B that developed after evacuation of a subdural hematoma. To our knowledge, this is the first such case report in Korea.
Aged ; Empyema, Subdural* ; Gastroenteritis ; Hematoma, Subdural* ; Humans ; Korea ; Salmonella Infections ; Salmonella*

Gas-containing (emphysematous) infections of the abdomen, pelvis, and extremities are well-known disease entities, which can potentially be life-threatening. They require aggressive medical and often surgical treatment. In the neurosurgical field, some cases of gas-containing brain abscess and subdural empyema have been reported. Sometimes they progress rapidly and even can cause fatal outcome. However, gas-containing spinal epidural abscess has been rarely reported and clinical course is unknown. We report on a case of rapidly progressive gas-containing lumbar spinal epidural abscess due to Enterococcus faecalis in a 72-year-old male patient with diabetes mellitus.
Abdomen ; Aged ; Brain Abscess ; Diabetes Mellitus ; Empyema, Subdural ; Enterococcus faecalis ; Epidural Abscess* ; Extremities ; Fatal Outcome ; Humans ; Male ; Pelvis ; Spine

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.
Adolescent ; Anti-Bacterial Agents ; Brain Abscess ; Cavernous Sinus Thrombosis ; Central Nervous System ; Child* ; Diagnosis ; Empyema, Subdural* ; Fever ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans ; Inpatients ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Meningitis ; Orbit ; Paralysis ; Sinusitis*

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should be borne in mind in patient with pyogenic meningitis who exhibit neurological deterioration.
Adult ; Dura Mater ; Empyema, Subdural ; Humans ; Mastoid ; Mastoiditis ; Meningitis ; Mucous Membrane ; Sepsis ; Sinusitis ; Veins

Subdural empyema of the brain is an uncommon disorder that occurs more frequently in children than in adult. Authors report a very rare of subdural empyema following the subdural hygroma after mild head injury. The exact mechanism of infection is not known. However, we have to consider subdural infection as one of differential diagnosis in elderly patient with subdural hygroma when new abnormal density lesion is developed in the subdural space.
Adult ; Aged ; Brain ; Child ; Craniocerebral Trauma ; Diagnosis, Differential ; Empyema, Subdural ; Escherichia ; Escherichia coli ; Humans ; Subdural Effusion ; Subdural Space

Pott's puffy tumor is a rare clinical entity, which has been described as a subperiosteal abscess in the frontal bone secondary to frontal osteomyelitis. Pott's puffy tumor can be associated with venous thrombosis, epidural abscess, subdural empyema, and brain abscess. In the present paper, we describe our experience of treating a 59-year old man who complained of a headache and a swelling of forehead. Because of bilateral lesion and obstruction of frontal recess, an external approach of the frontal sinus was carried out. To our knowledge, this is the first report of Pott's puffy tumor involving the bilateral frontal sinus.
Abscess ; Brain Abscess ; Empyema, Subdural ; Epidural Abscess ; Forehead ; Frontal Bone ; Frontal Sinus ; Headache ; Osteomyelitis ; Pott Puffy Tumor ; Venous Thrombosis

This article presents the case of a bilateral chronic subdural hematoma which was contaminated with Klebsiella pneumoniae and resulted in a life-threatening central nervous system infection. After repeated of bilateral burr-hole drainage, the patient became hyperpyrexic and drowsy. Suppuration within the subdural space was suspected and then the patient underwent bilateral fronto-temporo-parietal craniotomies, and pus was evacuated. Its cultures revealed Klebsiella pneumoniae. Intravenous meropenem was given for 6 weeks. He recovered completely. Microorganisms like Klebsiella pneumoniae may directly infect the subdural space with iatrogenic contamination.
Central Nervous System Infections ; Craniotomy ; Drainage ; Empyema, Subdural ; Hematoma, Subdural, Chronic ; Humans ; Klebsiella ; Klebsiella pneumoniae ; Subdural Space ; Suppuration ; Thienamycins