title: Subdural empyema due to Enterococcus faecalis.
abstract: Central nervous system infections due to Enterococcus species are uncommon. We report the first case of subdural empyema due to Enterococcus faecalis. Following partial treatment of a middle ear infection due to Enterococcus species and mixed coliforms, the patient developed signs of meningeal involvement. A lumbar puncture showed a raised polymorph cell count, but was sterile on culture; broad-spectrum antimicrobial therapy with cefotaxime, flucloxacillin and metronidazole was commenced. Following development of focal neurological signs, a CT scan revealed a subdural collection. Drainage and culture of the pus yielded a pure growth of Enterococcus faecalis. This case demonstrates the need to remain aware of the ability of the Enterococcus to cause serious infections and to direct specific antimicrobial therapy accordingly.
authors.affiliation: Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: B L
authors.initials: BL
authors.lastname: Jones
authors.forename: M H
authors.initials: MH
authors.lastname: Wilcox
mesh_terms: D000293:Adolescent; D013354:Empyema, Subdural / Q000188:drug therapy / Q000382:microbiology*; D013293:Enterococcus faecalis / Q000187:drug effects; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D016896:Treatment Outcome