A Rare Cause of Calcified Subdural Empyema and Ventriculitis in a Pediatric Patient: Achromobacter Denitrificans

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Neuroimaging

Background:

• Intracranial infections pose significant morbidity in pediatric populations, particularly in developing nations.
• Hypogammaglobulinemia can be a predisposing factor for severe infections.

Purpose of the Study:

• To report the first pediatric case of subdural empyema and ventriculitis caused by Achromobacter denitrificans.
• To highlight the diagnostic challenges and clinical course of this rare infection.

Main Methods:

• Case presentation of a 2-year-old male with acute neurological symptoms.
• Utilized unenhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) for diagnosis.
• Involved surgical decompression and medical management.

Main Results:

• Diagnosis of subdural empyema and ventriculitis due to Achromobacter denitrificans.
• Imaging revealed a peripherally calcified extraaxial collection, brain edema, and midline shift.
• Despite aggressive treatment, the patient experienced a fatal outcome post-operatively.

Conclusions:

• Achromobacter denitrificans is a rare but severe pathogen in pediatric intracranial infections.
• Subdural empyema and ventriculitis require prompt diagnosis and aggressive management.
• This case underscores the importance of considering unusual pathogens in refractory infections.