title: Treatment of a subdural empyema complicated by intracerebral abscess due to Brucella infection.
abstract: A 55-year-old male presented with fever, stupor, aphasia, and left hemiparesis. A history of head trauma 3 months before was also reported. Cranial magnetic resonance imaging revealed slight contrast enhancement of lesions under the right frontal skull plate and right frontal lobe. Because of deterioration in nutritional status and intracranial hypertension, the patient was prepared for burr hole surgery. A subdural empyema (SDE) recurred after simple drainage. After detection of Brucella species in SDE, craniotomy combined with antibiotic treatment was undertaken. The patient received antibiotic therapy for 6 months (two doses of 2 g ceftriaxone, two doses of 100 mg doxycycline, and 700 mg rifapentine for 6 months) that resulted in complete cure of the infection. Thus, it was speculated that the preexisting subdural hematoma was formed after head trauma, which was followed by a hematogenous infection caused by Brucella species.
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Vascular Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: L
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: C
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: C
authors.initials: C
authors.lastname: Fu
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Hao
authors.affiliation: Department of Pathology, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China.
authors.forename: W
authors.initials: W
authors.lastname: Li
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D020201:Brain Hemorrhage, Traumatic / Q000150:complications; D002006:Brucellosis / Q000150:complications* / Q000628:therapy*; D003399:Craniotomy / Q000379:methods; D004322:Drainage / Q000379:methods; D013354:Empyema, Subdural / Q000382:microbiology* / Q000628:therapy*; D006408:Hematoma, Subdural / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents