Journal of
Clinical Pathology and Forensic Medicine

  • Abbreviation: J. Clin. Pathol. Forensic Med.
  • Language: English
  • ISSN: 2141-2405
  • DOI: 10.5897/JCPFM
  • Start Year: 2010
  • Published Articles: 28

Case Report

Infratentorial subdural empyema following pyogenic meningitis in an adult: A case report

Jhamb Rajat1*, Kumar Ashok1, Ranga Gajender Singh1 and Bineeta kashyap2.
1Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. 2Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Email: [email protected]

  •  Accepted: 05 April 2011
  •  Published: 31 May 2011

Abstract

Subdural empyema complicating meningitis is relatively common in infants, but is rare in adults. Further infratentorial subdural empyema represents only a small portion of all cases of subdural empyema. The overwhelming majority of infratentorial empyema cases follow a neglected otogenic sepsis, trauma or paranasal sinusitis. We describe a case of 26 years old male who was diagnosed as pyogenic meningitis and developed infratentorial subdural empyema without any evidence of otogenic infection, trauma or sinusitis. The patient was successfully treated with prolonged course of antibiotics without the need for surgical intervention. The infratentorial subdural empyema is a rare entity and its occurrence without any predisposing factor or trauma makes it rarer. Secondly, the primary modality of treatment of subdural empyema is surgical but the present case was treated without any surgical intervention making it further an unusual case. We wish to highlight that subdural empyema should be considered even in adult patients with suspected or proven bacterial meningitis who develop progressive deterioration in sensorium or focal neurological signs even without predisposing co-morbidities.

 

Key words: Meningitis, subdural empyema, infratentorial subdural empyema.