title: [Transformation from chronic subdural hematoma into subdural empyema following cat bites: a case report].
abstract: A 69-year-old man developed motor aphasia and right hemiparesis with severe headache, during the treatment of cellulitis and sepsis due to cat bites. Brain CT showed a low density, crescent-shaped lesion in the left subdural space, which was hypointense on brain diffusion-weighted imaging (DWI). One week later, when his neurological symptoms had worsened, the signal of the subdural lesion had changed to hyperintense on DWI. The lesion was capsule-shaped when enhanced by Gadolinium. The signal changes on DWI of the lesion indicated the existing hematoma had changed to an empyema, or so-called infected subdural hematoma, due to a hematogenous bacterial infection. Pasteurella multocida, a resident microbe in the oral cavity of cats, could be the responsible pathogen in this case. The patient recovered completely after treatment with intravenous high dose antibiotics. This is an important case report describing the transformation from a chronic subdural hematoma into a subdural empyema by DWI.
authors.affiliation: Department of Neurology, Nagaoka Red Cross Hospital.
authors.forename: Takuya
authors.initials: T
authors.lastname: Konno
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Sou
authors.initials: S
authors.lastname: Kasahara
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Umeda
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Oyake
authors.forename: Nobuya
authors.initials: N
authors.lastname: Fujita
mesh_terms: D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001733:Bites and Stings / Q000150:complications* / Q000382:microbiology*; D002415:Cats; D002443:Ceftriaxone / Q000008:administration & dosage; D002481:Cellulitis / Q000209:etiology / Q000382:microbiology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D004359:Drug Therapy, Combination; D013354:Empyema, Subdural / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology*; D006261:Headache / Q000209:etiology; D020200:Hematoma, Subdural, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D000077731:Meropenem; D010291:Paresis / Q000209:etiology; D010326:Pasteurella Infections / Q000150:complications* / Q000382:microbiology*; D016979:Pasteurella multocida; D018805:Sepsis / Q000209:etiology; D013845:Thienamycins / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D002443:Ceftriaxone; D000077731:Meropenem