Bilateral chronic subdural hematoma contaminated with Klebsiella pneumoniae : an unusual case.

This article presents the case of a bilateral chronic subdural hematoma which was contaminated with Klebsiella pneumoniae and resulted in a life-threatening central nervous system infection. After repeated of bilateral burr-hole drainage, the patient became hyperpyrexic and drowsy. Suppuration within the subdural space was suspected and then the patient underwent bilateral fronto-temporo-parietal craniotomies, and pus was evacuated. Its cultures revealed Klebsiella pneumoniae. Intravenous meropenem was given for 6 weeks. He recovered completely. Microorganisms like Klebsiella pneumoniae may directly infect the subdural space with iatrogenic contamination.

[1]  J. Steinberg,et al.  Subdural empyema and other suppurative complications of paranasal sinusitis. , 2011, The Lancet. Infectious diseases.

[2]  S. Murakami,et al.  [A case of infected subdural hematoma]. , 2007, No shinkei geka. Neurological surgery.

[3]  C. Ong,et al.  Subdural empyema post-chemoradiotherapy for nasopharyngeal carcinoma. , 2006, Singapore medical journal.

[4]  S. Ibayashi,et al.  Venous infarction secondary to septic cavernous sinus thrombosis. , 2006, Internal medicine.

[5]  S. Lad,et al.  Spectrum of intracranial subdural empyemas in a series of 45 patients: current surgical options and outcome. , 2004, Neurology India.

[6]  A. Kojima,et al.  Supra- and infratentorial subdural empyema secondary to septicemia in a patient with liver abscess--case report. , 2004, Neurologia medico-chirurgica.

[7]  P. Black,et al.  Low rate of venous thromboembolism after craniotomy for brain tumor using multimodality prophylaxis. , 2002, Chest.

[8]  M. Kaneko,et al.  [A case of infected subdural hematoma following chronic subdural hematoma irrigation]. , 2002, No to shinkei = Brain and nerve.

[9]  S. Norwood,et al.  Prospective evaluation of the safety of enoxaparin prophylaxis for venous thromboembolism in patients with intracranial hemorrhagic injuries. , 2002, Archives of surgery.

[10]  Chen Ss,et al.  Pneumocephalus secondary to septic thrombosis of the superior sagittal sinus: report of a case. , 2001 .

[11]  C. Luo,et al.  Pneumocephalus secondary to septic thrombosis of the superior sagittal sinus: report of a case. , 2001, Journal of the Formosan Medical Association = Taiwan yi zhi.

[12]  B. Weir.  Intracranial Subdural Empyemas in the Era of Computed Tomography: A Review of 699 Cases , 1999 .

[13]  N. Nathoo,et al.  Intracranial subdural empyemas in the era of computed tomography: a review of 699 cases. , 1999, Neurosurgery.

[14]  K. Nagata,et al.  Subdural empyema caused by hematogenous dissemination from an abscess in thigh to a preexisting chronic subdural hematoma--case report. , 1998, Neurologia medico-chirurgica.

[15]  T. Takizawa,et al.  Infected subdural effusion associated with resolving subdural hematoma--case report. , 1997, Neurologia medico-chirurgica.

[16]  F. Yamasaki,et al.  [A case of infected subdural hematoma complicating chronic subdural hematoma in a healthy adult man]. , 1997, No to shinkei = Brain and nerve.

[17]  J. Niwa,et al.  [Subdural abscess following chronic subdural hematoma]. , 1995, No shinkei geka. Neurological surgery.

[18]  J. Peter,et al.  Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. , 1993, Journal of neurosurgery.

[19]  L. Heier,et al.  Subdural and epidural empyemas: MR imaging. , 1989, AJR. American journal of roentgenology.

[20]  D. Uttley,et al.  Management of subdural empyema: a series of 24 cases. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[21]  A. Destée,et al.  Management of subdural intracranial empyemas should not always require surgery. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[22]  M. Swartz,et al.  Septic Thrombosis of the Dural Venous Sinuses , 1986, Medicine.

[23]  C. Tulleken,et al.  Subdural empyema A review of 48 patients , 1984, Clinical Neurology and Neurosurgery.