title: Subdural Empyema Complicating Bacterial Meningitis: A Challenging Diagnosis in a Patient with Polysubstance Abuse.
abstract: Subdural empyema (SDE) and cerebrovascular accident (CVA) are uncommon life-threatening complications of bacterial meningitis, which require urgent neurosurgical intervention to prevent adverse outcomes. Clinicians must be vigilant of the onset of focal neurologic deficits or seizure activity to establish the diagnosis of SDE. Streptococcus pneumoniae accounts for <1% of pyogenic brain abscesses. This case describes a presentation of community acquired 
  pneumococcal meningitis [corrected] in which the diagnosis of SDE with vasculitis induced CVA was confounded by concomitant substance abuse and sedation.
authors.affiliation: Department of Medicine, University of Florida, 653 W. 8th Street, Box L18, Jacksonville, FL 32209, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Dakkak
authors.affiliation: Department of Medicine, University of Florida, 653 W. 8th Street, Box L18, Jacksonville, FL 32209, USA.
authors.forename: William Russell
authors.initials: WR
authors.lastname: Cullinane
authors.affiliation: Department of Medicine, University of Florida, 653 W. 8th Street, Box L18, Jacksonville, FL 32209, USA.
authors.forename: Virin Rajiv Neil
authors.initials: VR
authors.lastname: Ramoutar