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[Postoperative recurrence of subdural empyema]

Y Romero-Pizarro1, M Muñoz-Algarra, C Fernández-Mateos

  • 1Servicios de Medicina Interna. Hospital Puerta de Hierro. Majadahonda. Madrid.

Neurocirugia (Asturias, Spain)
|July 12, 2011
PubMed

Insights

Recurrent subdural empyema caused by Proprionibacterium acnes can occur after surgery. Prompt microbiological diagnosis and appropriate sample handling are crucial for effective treatment of these rare central nervous system infections.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Microbiology

Background:

  • Subdural empyema is a serious post-surgical complication.
  • Proprionibacterium acnes is a skin commensal that can cause opportunistic infections.
  • Accurate microbiological diagnosis is essential for guiding treatment.

Observation:

  • A case of recurrent subdural empyema caused by P. acnes is presented.
  • The initial empyema lacked a microbiological diagnosis.
  • P. acnes is a slow-growing, gram-positive anaerobic organism.

Findings:

  • P. acnes is the second most common cause of post-surgical CNS infections after Staphylococcus aureus.
  • P. acnes demonstrates resistance to metronidazole and sensitivity to penicillin.
  • Optimal growth of P. acnes is achieved in anaerobic liquid media.

Implications:

  • Clinicians should consider P. acnes in postoperative CNS infections.
  • Proper sample processing and consultation with microbiology are vital.
  • Early identification and targeted antibiotic therapy can improve patient outcomes.

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