Yang RX, Chen B, Zhang Y, Yang Y, Xie S, He L, Shi J. Development of subdural empyema from subdural effusion after suppurative encephalitis: A case report. World J Clin Cases 2023; 11(10): 2315-2320 [PMID: 37122516 DOI: 10.12998/wjcc.v11.i10.2315]
Corresponding Author of This Article
Jian Shi, MM, Doctor, Department of Psychosomatic Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Fucheng District, Mianyang 621000, Sichuan Province, China. psychome@foxmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2023; 11(10): 2315-2320 Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2315
Development of subdural empyema from subdural effusion after suppurative encephalitis: A case report
Rui-Xi Yang, Bei Chen, Yun Zhang, Yao Yang, Shu Xie, Lin He, Jian Shi
Rui-Xi Yang, Department of Infectious Diseases, Mianyang Central Hospital, Mianyang 621000, Sichuan Province, China
Bei Chen, Yun Zhang, Yao Yang, Shu Xie, Lin He, Department of Psychosomatic Medicine, Mianyang Central Hospital, Mianyang 621000, Sichuan Province, China
Jian Shi, Department of Psychosomatic Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Author contributions: Yang RX and Chen B are contributed equally; Zhang Y, Yang Y, Xie S and He L performed the clinical investigation and cared for the patient; Yang RX and Chen B drafted the manuscripts; Shi J reviewed and revised the manuscripts; All authors have read and approved the final manuscript.
Supported bySichuan Provincial Health and Family Planning Commission, China, No. 17PJ088.
Informed consent statement: The patient gave written consent for their personal or clinical details along with any identifying images to be published in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Shi, MM, Doctor, Department of Psychosomatic Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Fucheng District, Mianyang 621000, Sichuan Province, China. psychome@foxmail.com
Received: December 13, 2022 Peer-review started: December 13, 2022 First decision: February 8, 2023 Revised: February 18, 2023 Accepted: March 10, 2023 Article in press: March 10, 2023 Published online: April 6, 2023 Processing time: 107 Days and 9.3 Hours
Abstract
BACKGROUND
Chronic subdural effusion is very common in the cranial imaging of middle-aged and older people. Herein, we report a patient misdiagnosed with subdural effusion, who was eventually diagnosed with chronic subdural empyema (SDE) caused by Streptococcus pneumoniae.
CASE SUMMARY
A 63-year-old man was brought to our emergency room with a headache, vomiting, and disturbed consciousness. Computed tomography (CT) revealed a bilateral subdural effusion at the top left side of the frontal lobe. Cerebrospinal fluid examination after lumbar puncture indicated suppurative meningitis, which improved after anti-infective therapy. However, the patient then presented with acute cognitive dysfunction and right limb paralysis. Repeat CT showed an increase in left frontoparietal subdural effusion, disappearance of the left lateral ventricle, and a shift of the midline to the right. Urgent burr hole drainage showed SDE that was culture-positive for Streptococcus pneumoniae. His condition improved after adequate drainage and antibiotic treatment.
CONCLUSION
Patients with unexplained subdural effusion, especially asymmetric subdural effusion with intracranial infection, should be assessed for chronic SDE. Early surgical treatment may be beneficial.
Core Tip: Detection of chronic subdural effusion is very common in the cranial imaging of middle-aged and older people. Herein, we report a patient misdiagnosed with subdural effusion, who was eventually diagnosed with chronic subdural empyema (SDE) caused by Streptococcus pneumoniae. Patients with unexplained subdural effusion, especially asymmetric subdural effusion with intracranial infection, should be assessed for chronic SDE. Early surgical treatment may be beneficial.
