title: Review of the Management of Infected Subdural Hematoma.
abstract: OBJECTIVE
  Infection of a subdural hematoma is an unusual cause of subdural empyema, with fewer than 50 cases reported in the literature. The appropriate surgical option for this entity has not been determined because of its rarity. We present a case report of a post-traumatic subdural hematoma infected with Escherichia coli that was successfully treated with craniotomy. In addition, we performed a PubMed search to comprehensively illustrate the causative organism, source of infection, clinical picture, surgical treatment, and outcome for this condition. This article presents an update on the condition.
  
  
  METHODS
  A 55-year-old man was admitted to our hospital complaining of headache, seizure, and urinary incontinence. He had a history of alcoholism and several hospitalizations for mild head trauma. Neuroimaging studies revealed a chronic hematic collection in the left frontal-parietal region. Laboratory tests showed increased C-reactive protein levels. In addition, surgical results revealed an infected subdural hematoma. A bacterial culture of the purulent specimen identified E. coli. In view of the urinary complaint and leukocyturia, the cause of the infected subdural hematoma was postulated as a urinary tract infection.
  
  
  CONCLUSIONS
  Infected subdural hematoma is an unusual disorder. We must keep in mind the possibility of this complication when seeing a patient who presents with any of the 3 most common symptoms in this review. In these patients, craniotomy should be the method of surgical drainage, especially in adults. It ensures maximal drainage of the loculated pus and allows the total removal of the infected hematoma capsule.
authors.affiliation: Department of Neurosurgery, Hospital Municipal do Campo Limpo, São Paulo, Brazil. Electronic address: carlosdabdoub@hotmail.com.
authors.forename: Carlos B
authors.initials: CB
authors.lastname: Dabdoub
authors.affiliation: Department of Neurosurgery, Hospital Municipal do Campo Limpo, São Paulo, Brazil.
authors.forename: Juan Oscar
authors.initials: JO
authors.lastname: Adorno
authors.affiliation: Department of Neurosurgery, Hospital Municipal do Campo Limpo, São Paulo, Brazil.
authors.forename: Jair
authors.initials: J
authors.lastname: Urbano
authors.affiliation: School of Medicine, University City of São Paulo, São Paulo, Brazil.
authors.forename: Elisabeth N
authors.initials: EN
authors.lastname: Silveira
authors.affiliation: Department of Epidemiology and Biostatistics, University São Francisco, Bragança Paulista, Brazil.
authors.forename: Bianca Maria M
authors.initials: BM
authors.lastname: Orlandi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002494:Central Nervous System Infections / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D004927:Escherichia coli Infections / Q000628:therapy; D046648:Hematoma, Subdural, Intracranial / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents
keywords: Chronic subdural hematoma; Escherichia coli; Infected subdural hematoma; Subdural empyema