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Infected subdural effusion associated with resolving subdural hematoma--case report
Abstract:
A 70-year-old male presented with rapid neurological deterioration and fever 3 months after suffering a closed head trauma. He underwent craniotomy for possible subdural empyema based on computed tomography and clinical findings. Dural incision revealed an outer membrane typical of chronic subdural hematoma which covered a clear, yellowish fluid containing Campylobacter fetus. Histological examination confirmed the capsule of the hematoma, with a necrotic focus infiltrated by neutrophils. Administration of intravenous imipenem and topical tobramycin and cefalothin achieved total resolution of his neurological deficits. Development of the infected subdural effusion was probably secondary to bacterial infection in the pre-existing chronic subdural hematoma in the resolving stage. The presence of the hematoma capsule always carries the risk of development of an infectious focus.
Insights
A rare case of Campylobacter fetus infection in a chronic subdural hematoma led to rapid neurological decline. Prompt antibiotic treatment resolved the infection and neurological symptoms, highlighting the risk of infection in subdural hematomas.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Chronic subdural hematomas (CSDH) can present with varied complications.
- Infection within a CSDH is a rare but serious event.
- Campylobacter fetus is an uncommon pathogen, particularly in this context.