Epidural abscess and subdural empyema.

Epidural abscess and subdural empyema are serious intracranial infections that result in significant morbidity and mortality. Frequently, they are secondary to sinusitis or middle ear disease, and the bacteria involved are inhabitants of the upper respiratory tract. Symptoms may be mild and mimic the symptoms of the underlying infection. However, especially with subdural empyema, alteration in the level of consciousness and focal neurologic deficits are common. Morbidity and mortality are minimized by early diagnosis, which is best made with computed tomography scanning, and proper therapy, which consists of surgical drainage and administration of appropriate antimicrobials. It is important that primary care physicians be aware of the clinical features of these potentially fatal complications of common infections.