Giant subdural empyema in adult
Omar Boulahroud, Okacha Naama
The Pan African Medical Journal. 2018;29:103. doi:10.11604/pamj.2018.29.103.14822

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Giant subdural empyema in adult

Cite this: The Pan African Medical Journal. 2018;29:103. doi:10.11604/pamj.2018.29.103.14822

Received: 10/01/2018 - Accepted: 26/01/2018 - Published: 07/02/2018

Key words: Giant subdural empyema, craniotomy, Morocco

© Omar Boulahroud et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/29/103/full

Corresponding author: Omar Boulahroud, Departement of Neurosurgery, Military Hospital My Ismail, Meknes, Morocco (omarboulahroud78@outlook.fr)


Giant subdural empyema in adult

Omar Boulahroud1,&, Okacha Naama1

 

1Departement of Neurosurgery, Military Hospital My Ismail, Meknes, Morocco

 

 

&Corresponding author
Omar Boulahroud, Departement of Neurosurgery, Military Hospital My Ismail, Meknes, Morocco

 

 

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Subdural empyema (SDE) is a fairly uncommon diagnosis, accounting for only 20% of intracranial infections, the usual source for SDE is direct extension from a contiguous source, such as acute sinusitis or otitis media, although in one-fourth of cases no source of infection is found. An 18-year-old man was admitted to our Institution because of dysarthria, lethargy and fever for 2 days. His medical history was marked by chronic otitis media badly treated by self-medication with several antibiotics. The first clinical examination revealed an increased body temperature of 37.6°C, heart rate of 82 beats per minute, blood pressure 140/74mmHg and respiratory rate of 18 breaths/minute. He was disorientated, his cranial nerves were intact and his pupils were reactive, round and equal. His white cell count was 6,620 per μL. His hemoglobin was 11.1g/dL and C-reactive protein was 80mg/L. The levels of his chemistries were normal. A computed tomography (CT) scan with contrast in emergency was performed and showed an extensive subdural fluid collection in the parietal site on the left side with peripheral enhancement, a mass effect was evident with displacement of the middle line structures toward the opposite side (A). An emergent craniotomy was done to evacuate the subdural empyema (B). A cultural examination was attempted with the fluid evacuation and showed no presence of bacteroides. Ceftriaxone and metronidazole were administered for 6 weeks. The patient was improved without neurological sequalae.

 

 

Figure 1: (A) axial cerebral CT scan cut with contrast and; (B) peroperative view of giant subdural empyema

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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