[Case of bilateral subdural empyema complicating Campylobacter fetus subspecies fetus meningitis].
Campylobacter fetus subspecies fetus (C. fetus) is a relatively rare cause of meningitis, with only 3 cases of C. fetus subdural empyema reported to date. We experienced a case of bilateral subdural empyema complicating C. fetus meningitis. A 51-year-old man was found lying unconscious on a street and was brought to the hospital in an ambulance. He had no past history of any underlying disease but he had suffered head trauma approximately 1 month prior to this episode. On admission, he had high fever and developed a convulsion fit. Because the cerebrospinal fluid (CSF) findings showed mononuclear dominant pleocytosis and Gram staining revealed spiral-shaped gram negative bacilli, meningitis caused by C. fetus was suspected. Brain CT preformed on admission did not reveal any obvious abnormality. He was immediately treated with antibiotics effective against C. fetus. His disease was complicated by bilateral subdural empyema; therefore, bilateral burr hole drainage was performed. Durling the operation, a hematoma with an outer membrane and containing yellowish pus was revealed. Infection of a chronic subdural hematoma and consequent formation of subdural empyema was deduced. Eventually, C. fetus was isolated from the CSF arterial blood and subdural empyema. The patient was discharged with no complication after the completion of the treatment.
Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, Japan.
Seisaku
S
Kanayama
Kenji
K
Ohnishi
Tadayoshi
T
Yamaura
Mituya
M
Katayama
Jun
J
Makino
Nobuhiko
N
Takemura
Yuichi
Y
Hamabe
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002169:Campylobacter Infections; D002168:Campylobacter fetus / Q000302:isolation & purification*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004322:Drainage; D013354:Empyema, Subdural / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D020200:Hematoma, Subdural, Chronic / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D008875:Middle Aged; D013492:Suppuration; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents