Subdural empyema causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Subdural empyema}}
{{Subdural empyema}}
{{CMG}}; {{AE}} {{JS}}
{{CMG}} {{AE}} {{JS}}; {{AG}}


==Overview==
==Overview==
Subdural empyema, also referred to as [[subdural abscess]], [[pachymeningitis interna]] and [[circumscript meningitis]], is a life-threatening [[infection]].<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> It consists of a localised collection of [[pus|purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]] and accounts for about 15-22% of the reported focal intracranial [[infections]]  The [[empyema]] may develop intracranially (about 95%) or in the [[spinal canal]] (about 5%), and in both cases, it constitutes a [[medical emergency|medical]] and [[surgical emergency|neurosurgical emergency]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
Common causes of subdural empyema include [[Streptococci]], [[Staphylococci]], and other [[Gram-negative]] [[bacilli]].<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> In children, the majority of cases of subdural empyema occur due to [[meningitis]], while in adults the most common causes are [[sinusitis]], [[otitis media]], [[mastoiditis]], and [[trauma]].<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid16777239">{{Cite journal|author=Quraishi H, Zevallos JP |title=Subdural empyema as a complication of sinusitis in the pediatric population |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=70 |issue=9 |pages=1581–6 |year=2006 |month=September |pmid=16777239 |doi=10.1016/j.ijporl.2006.04.007 |url=http://linkinghub.elsevier.com/retrieve/pii/S0165-5876(06)00135-2}}</ref>
Depending on the site of origin of the [[infection]], as well as location of the empyema in the [[subdural space]], there will be different causative agents. The rate of success of growth of bacterial cultures, from the surgically removed pus is 54-81%. Common agents of subdural empyema include: [[anaerobes]], [[aerobic]] [[streptococci]], [[staphylococci]], ''[[Haemophilus influenzae]]'', ''[[Streptococcus pneumoniae]]'' and other [[gram-negative]] [[bacilli]]. <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref>
In children, subdural empyema most often happens as a complication of [[meningitis]] while in adults it usually occurs as a complication of [[sinusitis]], [[otitis media]], [[mastoiditis]], [[trauma]] or as a complication of neurological procedures.<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid16777239">{{Cite journal|author=Quraishi H, Zevallos JP |title=Subdural empyema as a complication of sinusitis in the pediatric population |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=70 |issue=9 |pages=1581–6 |year=2006 |month=September |pmid=16777239 |doi=10.1016/j.ijporl.2006.04.007 |url=http://linkinghub.elsevier.com/retrieve/pii/S0165-5876(06)00135-2}}</ref>


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Considering the location of the [[infection]]  the rapid progress it might have, as well as the structures affected, subdural empyema is considered a life-threatening entity in itself. Therefore, any of the causative agents and situations that may lead to the development of a subdural empyema should be considered life-theratening causes.
Subdural empyema is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in mortality or permanent disability within 24 hours if left untreated.


===Common Causes===
===Common Causes===
====Adults====
====Adults====
*Intracranial subdural empyema <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref name="pmid234678">{{cite journal| author=Yoshikawa TT, Chow AW, Guze LB| title=Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature. | journal=Am J Med | year= 1975 | volume= 58 | issue= 1 | pages= 99-104 | pmid=234678 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=234678  }} </ref>
'''Intracranial subdural empyema''' <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref name="pmid234678">{{cite journal| author=Yoshikawa TT, Chow AW, Guze LB| title=Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature. | journal=Am J Med | year= 1975 | volume= 58 | issue= 1 | pages= 99-104 | pmid=234678 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=234678  }} </ref>
The most common cause of subdural empyema in adults is the complication of an [[infection]] of the air sinuses: [[frontal air sinus|frontal]], [[ethmoid sinus|ethmoid]], [[sphenoidal sinuses|sphenoid]] and [[maxillary sinus|maxillary]]. The causative organisms of the empyema will be similar to those causing the infection of the sinuses, as well as other possible causes, such as [[epidural abscess]] and [[brain abscess]]. Generally multiple organisms are present in the empyema, where [[anaerobes]] are almost always an important agent. <ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref name="pmid234678">{{cite journal| author=Yoshikawa TT, Chow AW, Guze LB| title=Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature. | journal=Am J Med | year= 1975 | volume= 58 | issue= 1 | pages= 99-104 | pmid=234678 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=234678  }} </ref>


{| class="wikitable"
The most common cause of subdural empyema in adults is the complication of an [[infection]] of the air sinuses: [[frontal air sinus|frontal]], [[ethmoid sinus|ethmoid]], [[sphenoidal sinuses|sphenoid]], and [[maxillary sinus|maxillary]]. The causative organisms of the empyema are similar to those causing the infection of the sinuses. Generally multiple organisms are present in the empyema, where [[anaerobes]] are almost always an important agent.<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref name="pmid234678">{{cite journal| author=Yoshikawa TT, Chow AW, Guze LB| title=Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature. | journal=Am J Med | year= 1975 | volume= 58 | issue= 1 | pages= 99-104 | pmid=234678 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=234678  }} </ref>
|style="border-style:solid; border-width: 1px; border-color: #4479BA; text-align:center; width: 350px; background: #A1BCDD; color: white;" | '''Common causative agents'''
Common causative agents include:
|-
*[[Anaerobes]]
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Anaerobes
*Aerobic ''[[Streptococci]]''
|-
**''[[Streptococcus milleri]]''
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Aerobic ''Streptococci''
**''[[Streptococcus anginosus]]''
|-
**''[[Streptococcus pneumoniae]]''
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Staphylococci''
*''[[Staphylococci]]''
|-
*''[[Haemophilus influenzae]]''
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Haemophilus influenzae''
*[[Gram-negative]] [[bacilli]]
|-
 
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Streptococcus pneumoniae''
'''Spinal Subdural Empyema''' <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Other gram-negative ''bacilli''
|-
|}


{| class="wikitable"
*''[[Staphylococcus aureus]]''
|style="border-style:solid; border-width: 1px; border-color: #4479BA; text-align:center; width: 350px; background: #A1BCDD; color: white;" | '''Common causative agents from sinusitis'''
*''[[Streptococci]]''
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Anaerobes
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Aerobic ''Streptococcus milleri''
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Aerobic ''Streptococcus anginosus''
|}


====Children====
The most common cause of subdural empyema in children is occurs as a complication of [[meningitis]]. The agents isolated from the [[pus]], are usually similar to the ones causing the [[meningitis]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref>{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = 0-443-06839-9 | pages =  }}</ref> Common causative agents include:
*''[[Haemophilus influenzae]]''
*''[[Streptococcus pneumoniae]]''
*Nontyphoidal ''[[Salmonella]]''


*Spinal Subdural Empyema <ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref><ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
====Adults and Children====
{| class="wikitable"
Common causative agents in trauma include:
|style="border-style:solid; border-width: 1px; border-color: #4479BA; text-align:center; width: 350px; background: #A1BCDD; color: white;" | '''Common causative agents'''
*[[Coagulase]] negative strains of ''[[Staphylococcus]]''
|-
*[[Anaerobes]]
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Staphylococcus aureus''
*[[Gram-negative]] microbes
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Aerobic ''Streptococci''
|}


====Children====
Common causative agents in [[neurosurgery|neurosurgical procedures]] include:
The most common cause of subdural empyema in children is the complication of [[meningitis]]. The agents isolated from the pus are usually similar to the ones causing [[meningitis]]. <ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref><ref>{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = 0-443-06839-9 | pages =  }}</ref>
*''[[Pseudomonas aeruginosa]]''
{| class="wikitable"
*''[[Clostridium]]''
|style="border-style:solid; border-width: 1px; border-color: #4479BA; text-align:center; width: 350px; background: #A1BCDD; color: white;" | '''Common causative agents'''
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Haemophilus influenzae''
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;Aerobic ''Streptococcus pneumoniae''
|-
|style="border-style:solid; border-width: 1px; border-color: #4479BA; width: 350px; background: #4479BA; color: white;" | &nbsp;&nbsp;▸&nbsp;&nbsp;''Nontyphoidal Salmonella''
|}


==Causes by Organ System==
==Causes by Organ System==
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| Coagulase-negative strains of [[staphylococcus]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[a-hemolytic streptococci]], [[anaerobic]] [[streptococci]], nonhemolytic [[streptococci]], ''[[staphylococcus aureus]]'', ''Bacteroides'' species, ''[[Enterobacteriaceae]]'', ''[[Pseudomonas aeruginosa]]''
|bgcolor="Beige"| A-hemolytic [[streptococci]], [[Aerobic streptococci]], [[Anaerobes]], [[Anaerobic]] [[streptococci]], [[Bacteroides]] species, [[Enterobacteriaceae]], [[Klebsiella pneumoniae]], [[Neisseria meningitidis]], [[Otitis media]], [[Pseudomonas aeruginosa]], [[Sinusitis]], [[Staphylococci]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Clostridium difficile]], [[Enterobacteriaceae]], [[Escherichia coli]], [[Group-B streptococcus]], [[Listeria monocytogenes]], Nontyphoidal [[salmonella]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Campylobacter fetus]], Nonhemolytic [[streptococci]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| ''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]''
|bgcolor="Beige"| Neurological procedures, [[Surgery]],''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]''
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Brain abscess]], [[Epidural abscess]], [[Mastoiditis]], [[Meningitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| ''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]'', ''[[Haemophilus influenzae]]'', ''[[Escherichia coli]]'', ''[[streptococcus pneumoniae]]'', ''[[Neisseria meningitidis]]''
|bgcolor="Beige"| [[Brain abscess]], [[Epidural abscess]], [[Mastoiditis]], [[Meningitis]], Neurological procedures, [[Surgery]], [[Trauma]],''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]'', ''[[Haemophilus influenzae]]'', ''[[Escherichia coli]]'', ''[[streptococcus pneumoniae]]'', ''[[Neisseria meningitidis]]''
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| ''[[Streptococcus pneumoniae]]'', ''[[Klebsiella pneumoniae]]''
|bgcolor="Beige"| [[Aerobic streptococci]], [[Anaerobes]], Coagulase-negative strains of [[staphylococcus]], [[Haemophilus influenzae]], ''[[Klebsiella pneumoniae]]'', [[Neisseria meningitidis]], [[Pseudomonas aeruginosa]], [[Staphylococci]], ''[[Streptococcus pneumoniae]]''
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| Group-B streptococcus
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| ''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]'', ''[[Enterobacteriaceae]]''
|bgcolor="Beige"| [[Trauma]], ''[[staphylococcus aureus]]'', ''[[staphylococcus epidermidis]]'', ''[[Enterobacteriaceae]]''
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| A-hemolytic [[streptococci]], [[Anaerobes]], [[Anaerobic]] [[streptococci]], [[Bacteroides]] species, [[Brain abscess]], [[Campylobacter fetus]], [[Clostridium difficile]], Coagulase-negative strains of [[staphylococcus]], [[Enterobacteriaceae]], [[Epidural abscess]], [[Escherichia coli]], [[Gram-negative bacilli]], [[Haemophilus influenzae]], [[Klebsiella pneumoniae]], [[Listeria monocytogenes]], [[Neisseria meningitidis]], Nonhemolytic [[streptococci]], Nontyphoidal [[salmonella]], [[Sinusitis]], [[Staphylococci]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]], [[Streptococci]], [[Streptococcus]] anginosus, [[Streptococcus]] milleri, [[Streptococcus pneumoniae]]
|-
|-
|}
|}


===Causes in Alphabetical order===
===Causes in Alphabetical order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*A-hemolytic [[streptococci]]
*[[Aerobic streptococci]]
*[[Anaerobes]]
*[[Anaerobic]] streptococci
*[[Bacteroides]] species
*[[Brain abscess]]
*[[Campylobacter fetus]]
*[[Clostridium difficile]]
*Coagulase-negative strains of [[staphylococcus]]
*[[Enterobacteriaceae]]
*[[Epidural abscess]]
*[[Escherichia coli]]
*[[Gram-negative bacilli]]
*[[Group-b streptococcus]]
*[[Haemophilus influenzae]]
{{col-break|width=33%}}
*[[Klebsiella pneumoniae]]
*[[Listeria monocytogenes]]
*[[Mastoiditis]]
*[[Meningitis]]
*[[Neisseria meningitidis]]
*Neurological procedures
*Nonhemolytic [[streptococci]]
*Nontyphoidal[[ salmonella]]
*[[Otitis media]]
*[[Pseudomonas aeruginosa]]
*[[Sinusitis]]
*[[Staphylococci]]
*[[Staphylococcus aureus]]
*[[Staphylococcus epidermidis]]
*[[Streptococci]]
{{col-break|width=33%}}
*[[Streptococcus]] anginosus
*[[Streptococcus]] milleri
*[[Streptococcus pneumoniae]]
*[[Surgery]]
*[[Trauma]]
{{col-end}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
 
[[Category:Infectious disease]]


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Latest revision as of 18:53, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]

Overview

Common causes of subdural empyema include Streptococci, Staphylococci, and other Gram-negative bacilli.[1] In children, the majority of cases of subdural empyema occur due to meningitis, while in adults the most common causes are sinusitis, otitis media, mastoiditis, and trauma.[1][2]

Causes

Life Threatening Causes

Subdural empyema is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in mortality or permanent disability within 24 hours if left untreated.

Common Causes

Adults

Intracranial subdural empyema [1][3][4]

The most common cause of subdural empyema in adults is the complication of an infection of the air sinuses: frontal, ethmoid, sphenoid, and maxillary. The causative organisms of the empyema are similar to those causing the infection of the sinuses. Generally multiple organisms are present in the empyema, where anaerobes are almost always an important agent.[3][4] Common causative agents include:

Spinal Subdural Empyema [1][3]

Children

The most common cause of subdural empyema in children is occurs as a complication of meningitis. The agents isolated from the pus, are usually similar to the ones causing the meningitis.[3][5] Common causative agents include:

Adults and Children

Common causative agents in trauma include:

Common causative agents in neurosurgical procedures include:

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Coagulase-negative strains of staphylococcus, Staphylococcus aureus, Staphylococcus epidermidis
Drug Side Effect No underlying causes
Ear Nose Throat A-hemolytic streptococci, Aerobic streptococci, Anaerobes, Anaerobic streptococci, Bacteroides species, Enterobacteriaceae, Klebsiella pneumoniae, Neisseria meningitidis, Otitis media, Pseudomonas aeruginosa, Sinusitis, Staphylococci, Staphylococcus aureus, Staphylococcus epidermidis
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Clostridium difficile, Enterobacteriaceae, Escherichia coli, Group-B streptococcus, Listeria monocytogenes, Nontyphoidal salmonella
Genetic No underlying causes
Hematologic Campylobacter fetus, Nonhemolytic streptococci
Iatrogenic Neurological procedures, Surgery,staphylococcus aureus, staphylococcus epidermidis
Infectious Disease Brain abscess, Epidural abscess, Mastoiditis, Meningitis
Musculoskeletal/Orthopedic No underlying causes
Neurologic Brain abscess, Epidural abscess, Mastoiditis, Meningitis, Neurological procedures, Surgery, Trauma,staphylococcus aureus, staphylococcus epidermidis, Haemophilus influenzae, Escherichia coli, streptococcus pneumoniae, Neisseria meningitidis
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Enterobacteriaceae, Group B streptococci, Listeria monocytogenes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Aerobic streptococci, Anaerobes, Coagulase-negative strains of staphylococcus, Haemophilus influenzae, Klebsiella pneumoniae, Neisseria meningitidis, Pseudomonas aeruginosa, Staphylococci, Streptococcus pneumoniae
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual Group-B streptococcus
Trauma Trauma, staphylococcus aureus, staphylococcus epidermidis, Enterobacteriaceae
Urologic No underlying causes
Miscellaneous A-hemolytic streptococci, Anaerobes, Anaerobic streptococci, Bacteroides species, Brain abscess, Campylobacter fetus, Clostridium difficile, Coagulase-negative strains of staphylococcus, Enterobacteriaceae, Epidural abscess, Escherichia coli, Gram-negative bacilli, Haemophilus influenzae, Klebsiella pneumoniae, Listeria monocytogenes, Neisseria meningitidis, Nonhemolytic streptococci, Nontyphoidal salmonella, Sinusitis, Staphylococci, Staphylococcus aureus, Staphylococcus epidermidis, Streptococci, Streptococcus anginosus, Streptococcus milleri, Streptococcus pneumoniae

Causes in Alphabetical order

References

  1. ↑ 1.0 1.1 1.2 1.3 Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
  2. ↑ Quraishi H, Zevallos JP (2006). "Subdural empyema as a complication of sinusitis in the pediatric population". Int. J. Pediatr. Otorhinolaryngol. 70 (9): 1581–6. doi:10.1016/j.ijporl.2006.04.007. PMID 16777239. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 3.2 3.3 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.
  4. ↑ 4.0 4.1 Yoshikawa TT, Chow AW, Guze LB (1975). "Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature". Am J Med. 58 (1): 99–104. PMID 234678.
  5. ↑ Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9.


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