Superimposed Propionibacterium Acnes Subdural Empyema in a Patient with Chronic Subdural Hematoma
Open Access
- 1 January 2009
- journal article
- Published by Korean Neurosurgical Society in Journal of Korean Neurosurgical Society
- Vol. 45 (1), 53-56
- https://doi.org/10.3340/jkns.2009.45.1.53
Abstract
The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.Keywords
This publication has 10 references indexed in Scilit:
- Macrocephaly, Increased Intracranial Pressure, and Hydrocephalus in the Infant and Young ChildTopics in Magnetic Resonance Imaging, 2007
- Surgical Treatment Outcome of Subdural Empyema: A Clinical StudyPediatric Neurosurgery, 2006
- C-reactive protein: a valuable acute investigation. A case of pneumococcal meningitis presenting as ankle painEmergency Medicine Journal, 2005
- Propionibacterium infection associated with bovine pericardium dural allograftJournal of Neurosurgery, 2005
- Management of Epidural Abscesses and Subdural EmpyemasOperative Techniques in Neurosurgery, 2004
- Propionibacterium acnes causing delayed subdural empyema – a case report and review of literatureJournal of Clinical Neuroscience, 2004
- Focal Intracranial Infections Due to Propionibacterium acnes: Report of Three CasesNeurosurgery, 2001
- Infected subdural hematomaJournal of Clinical Neuroscience, 1998
- Isolation of Propionibacterium acnes from central nervous system infectionsAnaerobe, 1995
- Asymptomatic Calcified Chronic Subdural Hematoma —Report of Three Cases—Neurologia medico-chirurgica, 1993