Smith Kevin Andrew, Méndez Alejandra, Reese Lindsey J
Infectious Disease, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Internal Medicine, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Case Rep Infect Dis. 2025 Mar 19;2025:6625621. doi: 10.1155/crdi/6625621. eCollection 2025.
We report the first published case of causing subdural empyema. This 66-year-old male patient had relevant exposure history including living in a tent in the woods and having direct contact with wildlife. His main symptom which triggered his presentation was diplopia with exam findings consistent with a left partial oculomotor nerve palsy. Initial attempts at less invasive source control via burr holes alone failed. He was treated successfully with craniectomy and aqueous penicillin G with a duration of 6 weeks following surgery. CNS infection as the primary manifestation of has been reported in only one other case based on our review of the literature. This pathogen demonstrates an ability to manifest infection in many ways and remains susceptible to narrow spectrum beta-lactams.
我们报告了首例已发表的导致硬膜下积脓的病例。这位66岁的男性患者有相关暴露史，包括曾住在树林中的帐篷里并与野生动物有直接接触。引发其就诊的主要症状是复视，检查结果符合左侧部分动眼神经麻痹。最初仅通过钻孔进行的侵入性较小的源头控制尝试失败了。他接受了颅骨切除术和水剂青霉素G治疗，术后持续治疗6周，治疗成功。根据我们对文献的回顾，仅另有一例报告以中枢神经系统感染作为该病的主要表现。这种病原体显示出以多种方式引发感染的能力，并且仍然对窄谱β-内酰胺类药物敏感。
