Supra- and infratentorial subdural empyema secondary to septicemia in a patient with liver abscess--case report.
An 81-year-old man presented with subdural empyema in the left parietotemporal convexity 2 months after treatment under diagnoses of liver abscess and septicemia. Systemic investigation found no evidence of otorhinological or other focal infection except for liver abscess. Emergency drainage of pus was performed via a single burr hole and additional intravenous antibiotics were administered. Six weeks later, magnetic resonance imaging revealed subdural empyema in the right cerebellopontine angle in addition to recurrence of pus in the left parietotemporal subdural space. Ischemic changes were also shown in the right cerebellar hemisphere and brainstem. Although subdural empyema secondary to septicemia is rare, the possibility of this type of intracranial infection must be kept in mind, especially in compromised patients with septicemia.
Kojima
Atsuhiro
A
Department of Neurosurgery, Saitama Municipal Hospital, Saitama, Saitama, Japan. atsuhiro.kojima@nifty.com
Yamaguchi
Noriyuki
N
Okui
Shunichi
S
D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013354:Empyema, Subdural / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007710:Klebsiella Infections / Q000628:therapy*; D008100:Liver Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008297:Male