Infected Acute Subdural Hematoma Associated With Invasive Pneumococcal Disease : Case Report
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概要
- 論文の詳細を見る
A previously healthy 68-year-old woman presented with a rare case of subdural empyema which developed at the site of preceding acute subdural hematoma (SDH). She was first admitted for treatment of an acute SDH after a fall. Since she was neurologically intact and the SDH volume decreased with conservative management, she was discharged 9 days after admission for follow up as an outpatient. Three days after discharge, she unexpectedly returned with worsening headache and altered mental status. Brain computed tomography (CT) showed increased SDH volume. Her condition deteriorated rapidly after presentation, with further increase in SDH volume. Copious pus in addition to the SDH was evacuated by emergency drainage, establishing the diagnosis of subdural empyema. Streptococcus pneumoniae was identified from bacterial cultures. Despite improvement in postoperative CT findings, she fell into septic shock and died 3 days after the drainage. Autopsy revealed meningitis and lobar pneumonia, and the postmortem diagnosis was invasive pneumococcal disease. Infection of acute SDH resulting in subdural empyema by S. pneumoniae is extremely rare. However, invasive pneumococcal disease is not uncommon in the elderly and tends to cause intracranial bleeding. Considering the high mortality rate of invasive pneumococcal disease and the low vaccination rate among the elderly in Japan, neurosurgeons should ask about the pneumococcal vaccination status.
- 社団法人 日本脳神経外科学会の論文
- 2011-05-15
著者
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INAMASU Joji
Department of Neurosurgery, Saiseikai Utsunomiya Hospital
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Inamasu Joji
Department Of Neurosurgery Saiseikai Utsunomiya Hospital
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Muto Jun
Department Of Geoenvironmental Sciences Graduate School Of Science Tohoku University
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Kagami Hiroshi
Department Of Food Production Science Faculty Of Agriculture Shinshu University
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Kagami Hiroshi
Department Of Neurosurgery Saiseikai Utsunomiya Hospital
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NAKATUKASA Masashi
Department of Neurosurgery, Saiseikai Utsunomiya Hospital
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Nakatukasa Masashi
Department Of Neurosurgery Saiseikai Utsunomiya Hospital
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Muto Jun
Department Of Neurosurgery Saiseikai Utsunomiya Hospital
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Inamasu Joji
Department Of Neurosurgery Fujita Health University School Of Medicine
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MUTO Jun
Department of Earth Science, Tohoku University
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INAMASU Joji
Department of Emergency Medicine, Fujita Health University Hospital
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