Is the antibiotic prophylaxis useful in closed head injury? Infection of a closed cerebral hematoma

Abstract

We report an unusual case of a 55-year-old diabetic female who was initially managed conservatively for left temporal hematoma due to nonpenetrating head injury. 6 weeks after discharge she was brought to the emergency department with history of fever, headache, vomiting and altered sensorium of 2 days duration. A diagnosis of left temporal abscess was made on computed tomography scan. She improved after burr-hole evacuation of abscess and administration of appropriate antibiotics. She was not found to have any septic focus in body on investigations. Literature of pathogenesis of abscess developing over the intracerebral hematoma has been briefly reviewed. This case opens the debate for antibiotic prophylaxis in diabetic patients with cerebral hematoma due to closed head injury.