Sinogenic subdural empyema and Streptococcus anginosus.
Journal Article
Subdural empyema (SDE) is most commonly caused by sinusitis and, without early diagnosis and neurosurgical intervention, is associated with high mortality. In a patient with sinusitis who presents with mental status changes, the diagnosis of SDE should be suspected on clinical grounds, even in the absence of significant computed tomographic findings. Computed tomography with contrast is a useful aid in the diagnosis of SDE, but findings may be subtle, and contrasted magnetic resonance imaging is superior. The association of Streptococcus anginosus sinusitis and related intracranial sequelae is important owing to the potentially catastrophic complications and should be recognized by otolaryngologists. In view of the rapidly progressing nature of sinogenic SDE, physicians should strongly consider early institution of aggressive therapy consisting of craniotomy with concurrent sinus drainage in patients in whom sinogenic SDE is suspected on clinical grounds, particularly in the presence of S. anginosus-positive sinus cultures.
Full Text
Duke Authors
Cited Authors
- Hutchin, ME; Shores, CG; Bauer, MS; Yarbrough, WG
Published Date
- November 1999
Published In
Volume / Issue
- 125 / 11
Start / End Page
- 1262 - 1266
PubMed ID
- 10555700
Pubmed Central ID
- 10555700
International Standard Serial Number (ISSN)
- 0886-4470
Digital Object Identifier (DOI)
- 10.1001/archotol.125.11.1262
Language
- eng
Conference Location
- United States