Giant subdural empyema in adult
Omar Boulahroud, Okacha Naama
The Pan African Medical Journal. ;29:103. doi:10.11604/pamj..29.103.14822

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Giant subdural empyema in adult

Omar Boulahroud, Okacha Naama
Pan Afr Med J. 2018; 29:103. doi:10.11604/pamj.2018.29.103.14822. Published 07 Feb 2018

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 37.6C, 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 L. 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.

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

©Omar Boulahroud et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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