Abstract
Conservative treatment of subdural empyema: a complication of odontogenic sinusitis
Highlights
Subdural empyema is a purulent collection located in the space between the dura mater and the arachnoid mater [1]
Medical history points out recurrent upper respiratory infections and multiple neglected dental problems, over the past three months, for which the patient self-medicated with nonsteroidal anti-inflammatory drugs and unspecified antibiotics
At the beginning of the case history, the native CCT exam revealed maxillary sinusitis, that was associated with purulent meningitis, explained by the common etiology with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis
Summary
Subdural empyema is a purulent collection located in the space between the dura mater and the arachnoid mater [1]. The first line antibiotic treatment was Meropenem, but the clinical evaluation after 72 hours pointed out persistent fever, aggravation of the neurological status with 8 points on Glasgow Coma Scale and left hemibody seizures. The etiologic identification rate increases over three times in the case of the analysis of the aspirate in empyema using the molecular technique of 16S rRNA gene for bacteria, but this procedure is not routinely available yet [8].
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