RESUMO
Subdural empyema [SDE] is a significant cause of neurological morbidity and mortality. It should be recognized early and treated as an emergency. Although convexity subdural empyema is not so uncommon but parafalcine subdural empyema is quite rare. A recent case of parafalcine subdural empyema managed at Prince Abdullah Bin Abdulaziz Hospital, Bisha [KSA] is discussed. The epidemiology, pathophysiology, bacteriology, clinical features, radiographic findings and treatment of this life-threatening entity are reviewed
Assuntos
Humanos , Masculino , Empiema Subdural/terapia , Encéfalo/patologia , Empiema Subdural/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
El empiema subdural es una complicación rara de las infecciones por Salmonela. Se informa de un lactante con desnutrición grave y síndrome de Down, quien cursó con gastroenteritis aguda y bacteremia por Salmonella anteritidis que después de ser tratado con antibióticos fue dado de alta con aparente mejoría clínica. Un mes después desarrolló un síndrome febril y dificultad respiratoria, mostrando la fontanela anterior abombada; se agregaron crisis convulsivas focalizadas y deterioro cefalocaudal. El estudio microbiológico informó la presencia de bacilos gram negativos y se cultivó Salmonela enteritidis, sensible a cefotaxima. Fue tratado durante tres semanas con antibióticos para luego ser dado de alta
Assuntos
Lactente , Humanos , Masculino , Salmonella enteritidis/isolamento & purificação , Empiema Subdural/diagnóstico , Empiema Subdural/fisiopatologia , Empiema Subdural/tratamento farmacológico , Cefotaxima/uso terapêutico , Ampicilina/uso terapêutico , Metronidazol/uso terapêuticoRESUMO
Brain abscess and subdural empyema are serious infections which can be metastasis of chronic suppurative diseases (bronchectasia, lung orabdominal abscess) or of congenital cardiopathy, but they are more frequently seen in healthy adults suffering from chronic sinusitis or otitis. Brain CT scan with contrast media injection is the best tool for diagnosis and follow-up. It has transformed the prognosis of brain abscesses. Anaerobic oropharyngeal microflora is the main source of bacteria responsible for suppurative brain diseases. Surgical treatment consist of aspiration or, rarely now, of excision of the lesion. Medical treatment alone can be successfull in selected cases, provided patients are closely monitored and antibiotics with good penetration into the brain parenchyma are used