Chronic subdural empyema and cranial vault osteomyelitis due to Salmonella paratyphi A

P Bhooshan1, S Shivaprakasha, K R Dinesh

  • 1Department of Microbiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala 682 026, India.

Insights

This case report details a rare intracranial infection, subdural empyema, caused by Salmonella Paratyphi A. The patient recovered after surgical treatment and antibiotics.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Microbiology

Background:

  • Intracranial infections are uncommon, with subdural empyema being a rare manifestation.
  • Salmonella species, particularly Salmonella Paratyphi A, are infrequently implicated in causing subdural empyema.
  • Previous literature documents only one prior case of subdural empyema attributed to Salmonella Paratyphi A.

Observation:

  • A 42-year-old male presented with headache and purulent discharge from a burr hole wound site.
  • The patient had a history of head trauma two years prior, followed by surgical intervention for a chronic subdural hematoma.
  • Clinical examination revealed signs suggestive of a secondary infection at the surgical site.

Findings:

  • Cultures from the purulent discharge and surgical site confirmed the presence of Salmonella Paratyphi A.
  • The patient was diagnosed with subdural empyema and concurrent osteomyelitis of the cranial vault.
  • Microbiological analysis identified Salmonella Paratyphi A as the causative agent.

Implications:

  • This case highlights the potential for Salmonella Paratyphi A to cause severe intracranial infections, including subdural empyema and osteomyelitis.
  • Early diagnosis and appropriate antibiotic therapy combined with surgical intervention are crucial for favorable outcomes.
  • The findings underscore the importance of considering unusual pathogens in the differential diagnosis of intracranial infections, especially in patients with a history of trauma or neurosurgery.

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