Subdural empyema differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Subdural empyema must be differentiated from other diseases that cause [[fever]], [[headache]], focal neurological signs, [[seizures]], and altered mental status, such as [[subdural hematoma]], [[brain abscess]], and [[bacterial meningitis]]. | Subdural empyema must be differentiated from other diseases that cause [[fever]], [[headache]], focal neurological signs, [[seizures]], and altered mental status, such as [[subdural hematoma]], [[brain abscess]], and [[bacterial meningitis]]. These conditions may be distinguished from subdural empyema by their clinical findings, [[lumbar puncture]] results, brain imaging findings, and laboratory studies. | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Subdural empyema must be differentiated from other diseases that cause [[fever]], [[headache]], focal neurological signs, [[seizures]], and altered mental status, including:<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>{{Cite book | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages = }}</ref> | Subdural empyema must be differentiated from other diseases that cause [[fever]], [[headache]], focal neurological signs, [[seizures]], and altered mental status, including:<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>{{Cite book | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages = }}</ref> | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
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! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Disease}} | |||
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Findings}} | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Subdural hematoma]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with an accumulation of [[blood]] in the [[subdural space]], which frequently surges in the presence of trauma; it may cause an increase of [[intracranial pressure]] causing compression and damage to the [[brain]]. The acute form of this condition is considered a [[medical emergency]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Brain abscess]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Presents with an [[abscess]] in the [[brain]] caused by the [[inflammation]] and accumulation of [[infected]] material from local or remote infectious areas of the body; the infectious agent may also be introduced as a result of head [[trauma]] or [[neurosurgery|neurological procedures]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Bacterial meningitis]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Presents with [[inflammation]] of the [[meninges]], which may develop in the setting of an [[infection]], physical injury, [[cancer]], or certain drugs; it may have an indolent evolution, resolving on its own, or may present as an rapidly evolving [[inflammation]], causing neurologic damage and possible [[mortality]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral encephalitis]] ''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with acute [[inflammation]] of the [[brain]], caused by a [[viral infection]]; it may complicate into severe [[brain]] damage as the inflamed [[brain]] pushes against the [[skull]], potentially leading to [[mortality]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Epidural abscess]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with an [[abscess]] in the [[epidural space]], between the [[vertebrae]] and the [[dura mater]] of the [[spinal canal]]; it may complicate into [[spinal cord]] dysfunction, leading to [[paralysis]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Cerebral [[thrombophlebitis]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[inflammation]] of a cerebral [[vein]], related to a [[blood clot]] or [[thrombus]]; it can cause [[chronic pain]], leg [[swelling]], and [[pulmonary embolism]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Superior sagittal sinus thrombosis]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[thrombosis]] affecting the [[dural venous sinuses]], which drain blood from the [[brain]]; it can cause [[headache]]s, [[fever]], and increased [[intracranial pressure]]. | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Acute disseminated encephalomyelitis]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with scattered foci of [[demyelination]] and perivenular [[inflammation]]; it can cause focal neurological signs and decreased ability to focus. | |||
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==References== | ==References== | ||
Revision as of 21:11, 30 November 2015
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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
Subdural empyema must be differentiated from other diseases that cause fever, headache, focal neurological signs, seizures, and altered mental status, such as subdural hematoma, brain abscess, and bacterial meningitis. These conditions may be distinguished from subdural empyema by their clinical findings, lumbar puncture results, brain imaging findings, and laboratory studies.
Differential Diagnosis
Subdural empyema must be differentiated from other diseases that cause fever, headache, focal neurological signs, seizures, and altered mental status, including:[1][2]
| Disease | Findings |
|---|---|
| Subdural hematoma | Presents with an accumulation of blood in the subdural space, which frequently surges in the presence of trauma; it may cause an increase of intracranial pressure causing compression and damage to the brain. The acute form of this condition is considered a medical emergency. |
| Brain abscess | Presents with an abscess in the brain caused by the inflammation and accumulation of infected material from local or remote infectious areas of the body; the infectious agent may also be introduced as a result of head trauma or neurological procedures. |
| Bacterial meningitis | Presents with inflammation of the meninges, which may develop in the setting of an infection, physical injury, cancer, or certain drugs; it may have an indolent evolution, resolving on its own, or may present as an rapidly evolving inflammation, causing neurologic damage and possible mortality. |
| Viral encephalitis | Presents with acute inflammation of the brain, caused by a viral infection; it may complicate into severe brain damage as the inflamed brain pushes against the skull, potentially leading to mortality. |
| Epidural abscess | Presents with an abscess in the epidural space, between the vertebrae and the dura mater of the spinal canal; it may complicate into spinal cord dysfunction, leading to paralysis. |
| Cerebral thrombophlebitis | Presents with inflammation of a cerebral vein, related to a blood clot or thrombus; it can cause chronic pain, leg swelling, and pulmonary embolism. |
| Superior sagittal sinus thrombosis | Presents with thrombosis affecting the dural venous sinuses, which drain blood from the brain; it can cause headaches, fever, and increased intracranial pressure. |
| Acute disseminated encephalomyelitis | Presents with scattered foci of demyelination and perivenular inflammation; it can cause focal neurological signs and decreased ability to focus. |
References
- ↑ 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.
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.