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Year : 2000  |  Volume : 48  |  Issue : 3  |  Page : 297

Subdural Salmonella empyema in an adult.






How to cite this article:
Chandy M J. Subdural Salmonella empyema in an adult. Neurol India 2000;48:297


How to cite this URL:
Chandy M J. Subdural Salmonella empyema in an adult. Neurol India [serial online] 2000 [cited 2020 Dec 2];48:297. Available from: https://www.neurologyindia.com/text.asp?2000/48/3/297/1453



Subdural empyema is a well known complication following meningitis, sinusitis, trauma or septicaemia in the paediatric age group.[1],[2] It is almost always secondary to a primary site of infection which includes paranasal sinuses, middle ear, lungs and even cyanotic heart disease.[1],[4],[5] Although various organisms have been implicated, Salmonella has been rarely reported as the aetiological agent. It is rarely seen in adults.
A sixty six year old man presented with history of headache, seizures, right sided weakness and impaired cognition of four months duration. He had history of fever for two weeks. There was no past history of head trauma, sinusitis, ear discharge or any other known source of infection. He was not a known diabetic. Neurological examination showed a fully alert individual with gross bilateral papilloedema. He had right supranuclear facial palsy with right hemiparesis. Blood investigations including platelets and bleeding parameters were normal. MRI scan showed a subdural collection, hypointense on T1W images and hyperintense on T2W images in the left fronto-parietal region. He underwent evacuation of the subdural collection (pus) through frontal and parietal burr holes. Grams stain showed Gram negative bacilli. On culture, the pus grew Salmonella type D. He was started on ciprofloxacillin. There was significant improvement in his clinical status, and he was discharged after two weeks of parenteral antibiotics.
Adult subdural empyemas are a curiosity,[1],[2],[3],[6],[7],[8] and have been known to occur due to secondary infection of subdural haematoma. This report describes the rare occurrence of subdural empyema in an adult with Salmonella.

 

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1.Borzone M, Capuzzo T, Rivano C et al : Subdural empyema. Surg Neurol1980; 13 : 449-452.   Back to cited text no. 1    
2.Farmer TW, Wise GR : Subdural empyema in children and adults. Neurology1973; 23 : 254-261.   Back to cited text no. 2    
3.Post EM, Moderate LB : Subacute postoperative subdural empyema. J Neurosurg1981; 55 : 761-765.   Back to cited text no. 3    
4.Weisberg T : Subdural empyema. Arch Neurol 1986; 43 : 497-500.   Back to cited text no. 4    
5.Bok APL, Peter JC : Subdural empyema - Burr holes or craniotomy? A retrospective computed tomography-era analysis of treatment in 90 cases. J Neurosurg 1993; 78 : 574-578.   Back to cited text no. 5    
6.Bannister G, Williams B, Smith S : Treatment of subdural empyema. J Neurosurg1981; 55 : 82-88.   Back to cited text no. 6    
7.Mahapatra AK, Bhatia R : Salmonella intracerebral and subdural abscess. A report of two cases. Post Grad Med J 1987; 63 : 373-375.   Back to cited text no. 7    
8.Jain KC, Mahapatra AK : Subdural empyema due to Salmonella infection. Paedia Neurosurg1998; 28 : 89-90.   Back to cited text no. 8    

 

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Online since 20th March '04
Published by Wolters Kluwer - Medknow