title: Infected subdural effusion associated with resolving subdural hematoma--case report.
abstract: A 70-year-old male presented with rapid neurological deterioration and fever 3 months after suffering a closed head trauma. He underwent craniotomy for possible subdural empyema based on computed tomography and clinical findings. Dural incision revealed an outer membrane typical of chronic subdural hematoma which covered a clear, yellowish fluid containing Campylobacter fetus. Histological examination confirmed the capsule of the hematoma, with a necrotic focus infiltrated by neutrophils. Administration of intravenous imipenem and topical tobramycin and cefalothin achieved total resolution of his neurological deficits. Development of the infected subdural effusion was probably secondary to bacterial infection in the pre-existing chronic subdural hematoma in the resolving stage. The presence of the hematoma capsule always carries the risk of development of an infectious focus.
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Ohkubo Hospital.
authors.forename: N
authors.initials: N
authors.lastname: Aoki
authors.forename: T
authors.initials: T
authors.lastname: Sakai
authors.forename: A
authors.initials: A
authors.lastname: Oikawa
authors.forename: T
authors.initials: T
authors.lastname: Takizawa
authors.forename: T
authors.initials: T
authors.lastname: Shishido
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents; D002169:Campylobacter Infections / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002168:Campylobacter fetus; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003399:Craniotomy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D013354:Empyema, Subdural / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016489:Head Injuries, Closed / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D013353:Subdural Effusion / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013355:Subdural Space / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents