Development of subdural empyema from subdural effusion after suppurative encephalitis:A case report  

作　　者：Rui-Xi Yang Bei Chen Yun Zhang Yao Yang Shu Xie Lin He Jian Shi 

机构地区：[1]Department of Infectious Diseases,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China [2]Department of Psychosomatic Medicine,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China [3]Department of Psychosomatic Medicine,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2023年第10期2315-2320,共6页世界临床病例杂志

基　　金：Supported by Sichuan Provincial Health and Family Planning Commission,China,No.17PJ088.

摘　　要：BACKGROUND Chronic subdural effusion is very common in the cranial imaging of middle-aged and older people.Herein,we report a patient misdiagnosed with subdural effusion,who was eventually diagnosed with chronic subdural empyema(SDE)caused by Streptococcus pneumoniae.CASE SUMMARY A 63-year-old man was brought to our emergency room with a headache,vomiting,and disturbed consciousness.Computed tomography(CT)revealed a bilateral subdural effusion at the top left side of the frontal lobe.Cerebrospinal fluid examination after lumbar puncture indicated suppurative meningitis,which improved after anti-infective therapy.However,the patient then presented with acute cognitive dysfunction and right limb paralysis.Repeat CT showed an increase in left frontoparietal subdural effusion,disappearance of the left lateral ventricle,and a shift of the midline to the right.Urgent burr hole drainage showed SDE that was culture-positive for Streptococcus pneumoniae.His condition improved after adequate drainage and antibiotic treatment.CONCLUSION Patients with unexplained subdural effusion,especially asymmetric subdural effusion with intracranial infection,should be assessed for chronic SDE.Early surgical treatment may be beneficial.

关 键 词：Subdural effusion Subdural empyema Streptococcus pneumoniae MENINGOENCEPHALITIS Drainage Case report 

分 类 号：R651.1[医药卫生—外科学]