Gupta Anurag, Karanth Suman S, Raja A
Department of Neurosurgery, Adarsha Superspeciality Hospital, Udupi, Karnataka, India.
J Neurosci Rural Pract. 2013 Apr;4(2):213-5. doi: 10.4103/0976-3147.112773.
Infratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill-planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.
幕下硬膜下积脓是一种极其罕见的病症，不幸的是，75%的病例会表现出类似化脓性脑膜炎的症状。对这些病例进行计划不当的腰椎穿刺可能会致命，而治疗的意外延误可能对患者的预后不利。我们报告一例患有慢性化脓性中耳炎（CSOM）长期病史的小男孩，其出现幕下积脓并有提示化脓性脑膜炎的特征。我们还回顾了现有文献，以根据临床特征、治疗选择和预后进一步明确该病症。对这种病症误诊且未采取适当的手术干预和抗生素治疗可能会危及生命。我们强调这种罕见病症，尤其是在存在相关风险因素时，需要高度怀疑。
