Kojima Atsuhiro, Yamaguchi Noriyuki, Okui Shunichi
Department of Neurosurgery, Saitama Municipal Hospital, Saitama, Saitama, Japan.
Neurol Med Chir (Tokyo). 2004 Feb;44(2):90-3. doi: 10.2176/nmc.44.90.
An 81-year-old man presented with subdural empyema in the left parietotemporal convexity 2 months after treatment under diagnoses of liver abscess and septicemia. Systemic investigation found no evidence of otorhinological or other focal infection except for liver abscess. Emergency drainage of pus was performed via a single burr hole and additional intravenous antibiotics were administered. Six weeks later, magnetic resonance imaging revealed subdural empyema in the right cerebellopontine angle in addition to recurrence of pus in the left parietotemporal subdural space. Ischemic changes were also shown in the right cerebellar hemisphere and brainstem. Although subdural empyema secondary to septicemia is rare, the possibility of this type of intracranial infection must be kept in mind, especially in compromised patients with septicemia.
一名81岁男性在被诊断为肝脓肿和败血症并接受治疗2个月后,出现左侧顶颞叶凸面硬膜下积脓。全身检查发现,除肝脓肿外,没有耳鼻喉科或其他局部感染的证据。通过单个钻孔进行了紧急排脓,并额外给予了静脉抗生素治疗。六周后,磁共振成像显示右侧桥小脑角出现硬膜下积脓,同时左侧顶颞叶硬膜下间隙再次出现脓液。右侧小脑半球和脑干也出现了缺血性改变。虽然败血症继发的硬膜下积脓很少见,但必须牢记这种颅内感染的可能性,尤其是在患有败血症的免疫功能低下患者中。