Sinogenic subdural empyema and Streptococcus anginosus.

Journal Article (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

International Standard Serial Number (ISSN)

  • 0886-4470

Digital Object Identifier (DOI)

  • 10.1001/archotol.125.11.1262


  • eng

Conference Location

  • United States