A Review of Subdural Empyema and Its Management

Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, Jayaram

doi:10.1097/01.idc.0000269905.67284.c7

Cited by 44 publications

(90 citation statements)

References 38 publications

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“…The intracranial complications of sinusitis are meningitis, intracranial abscess, subdural empyema, epidural abscess, cavernous sinus thrombosis, and thrombosis of other dural sinuses [2]. Subdural empyema has been reported in 5-25% of intracranial infections, with 80% of all cases presenting in males aged between 10 and 40 years [7,5]. These findings are in accordance with our reported cases.…”

Section: Discussionsupporting

confidence: 83%

“…At the same time, the most common organisms in subdural empyema secondary to paranasal sinusitis are anaerobic, microaerophilic streptococci, and in particular, those of the Streptococcus milleri group (S. milleri and S. anginosus) [7]. In this case, we found cultural bacterial growth of S. epidermidis from pus taken from preseptal cellulitis.…”

Section: Discussionmentioning

confidence: 57%

“…Subdural empyema should be considered as a neurosurgical emergency, which means that aggressive treatment including multiple antibiotic administration and neurosurgery procedure should be carried out as soon as possible [11]. The principle of source control by the drainage of pus has to be mandatorily implemented, on the top of which craniotomy has been included as one of the favorable prognostic factors [7], although nonsurgical treatment (only with antibiotics) is still acceptable [23]. The main purpose of neurosurgical operation is to decrease the toxic and inflammatory process in the brain and surrounding vessels and also to reduce the mass effect of the subdural pus.…”

Section: Discussionmentioning

confidence: 99%

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Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

et al. 2017

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Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

et al. 2017

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“…[6] Nearly 80% of subdural empyemas are seen in men, and 60% of patients are between 10 and 40 years of age. [7] In developing countries, the most common intracranial complication of sinusitis is epidural abscess, which has a more favorable prognosis. Then in decreasing frequency, subdural empyema, meningitis, encephalitis, and brain abscess are seen.…”

Section: Discussionmentioning

confidence: 99%

A Case of Two Different Complications of Sinusitis: Orbital Abscess and Subdural Empyema

Yılmaz¹

2017

South Clin Ist Euras

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Today, in spite of improved diagnostic tools and appropriate antibiotic usage, life-threatening complications of sinusitis such as orbital abscess and subdural empyema can still be observed. These complications may cause serious, disabling sequelae. Presently described is case of 12-year-old girl with frontoethmoidal sinusitis as well as orbital abscess and subdural empyema. Prompt diagnosis and treatment resulted in uncomplicated outcome. For patients with subdural empyema, early diagnosis is possible with cranial magnetic resonance imaging (MRI) and surgery is not necessarily required for clinical improvement. Otolaryngologists should pay attention to additional symptoms such as confusion or loss of consciousness in patients with orbital abscess in order to diagnose a secondary complication such as subdural empyema promptly.

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“…Subdural empyema (SDE) is a fairly uncommon diagnosis, accounting for only 20% of intracranial infections 1. In children, the usual source for SDE is direct extension from a contiguous source, such as acute sinusitis or otitis media,1 although in one-fourth of cases no source of infection is found 2.…”

Section: Introductionmentioning

confidence: 99%

Streptococcal pharyngitis: an uncommon cause of subdural empyema

2015

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A 7-year-old girl with an unremarkable medical history presented to a local paediatric emergency department with a 7-day history of fever, sore throat and vomiting, and a 1-day history of rash. She was admitted to the hospital, with presumed Kawasaki disease. A few hours after admission, the patient had sudden onset of two witnessed tonic-clonic seizures and subsequent decreased mental status. She was transferred to the paediatric intensive care unit and started on broad-spectrum antibiotics. On hospital day 2, cerebral spinal fluid cultures and blood cultures grew Streptococcus pyogenes, and repeat physical examination was consistent with acute streptococcal pharyngitis. On hospital day 3, the patient developed left-sided hemiparesis and had another witnessed seizure. A CT scan was obtained and revealed a subdural abscess. She was transferred to a tertiary care centre and underwent craniotomy with evacuation of her subdural abscess. Surgical cultures eventually grew S. pyogenes.

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A Review of Subdural Empyema and Its Management

Abstract: Subdural empyema is a collection of purulent material between the dura mater and the arachnoid mater.

Cited by 44 publications

References 38 publications

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report

A Case of Two Different Complications of Sinusitis: Orbital Abscess and Subdural Empyema

Streptococcal pharyngitis: an uncommon cause of subdural empyema

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