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<h5>Subdural empyema {{ID-returntotop-organ}}</h5>
<h5>Subdural empyema {{ID-returntotop-organ}}</h5>


* Subdural empyema
* Subdural empyema<ref>{{Cite journal| doi = 10.1016/S1473-3099(06)70688-0| issn = 1473-3099| volume = 7| issue = 1| pages = 62–67| last1 = Osborn| first1 = Melissa K.| last2 = Steinberg| first2 = James P.| title = Subdural empyema and other suppurative complications of paranasal sinusitis| journal = The Lancet. Infectious Diseases| date = 2007-01| pmid = 17182345}}</ref>
:* Causative pathogens
:* Causative pathogens
::* More common
::* More common

Revision as of 03:38, 8 June 2015

Subdural empyema ⇧ Return to Top ⇧
  • Subdural empyema[1]
  • Causative pathogens
  • More common
  • Streptococcus milleri
  • Other streptococci and enterococci
  • Aerobic Gram-negative bacilli (Haemophilus influenzae, Proteus, Escherichia coli, Pseudomonas, Klebsiella, Acinetobacter, Salmonella, Morganella, Eikenella)
  • No growth
  • Less common
  • Streptococcus pneumoniae
  • Staphylococcus aureus, coagulase-negative staphylococci
  • Anaerobic Gram-positive cocci (Veillonella, Peptostreptococcus, others)
  • Anaerobic Gram-negative bacilli (Bacteroides, Fusobacterium, Prevotella)
  • Empiric antimicrobial therapy
  • Infants < 1 month
  • Infants 1–3 months
  • Infants > 3 months
  • Adults < 55 years
  • Adults ≥ 55 years, alcoholics, or with debilitating illness
  • Impaired cell-mediated immunity or hospital-acquired, post-neurosurgery, or post-traumatic meningitis (pediatric)
  • Impaired cell-mediated immunity or hospital-acquired, post-neurosurgery, or post-traumatic meningitis (adult)
Note (1): The choice of antimicrobial agent should be based on Gram stain results and the likely causative microorganisms.
Note (2): Metronidazole is recommended if anaerobes are suspected. For infection likely caused by aerobic gram-negative bacilli, empirical therapy with Cefepime, Ceftazidime, or Meropenem is appropriate, pending microorganism identification and in vitro susceptibility testing. Metronidazole is not necessary for antianaerobic activity if meropenem is used.
Note (3): Depending on the clinical response, parenteral antimicrobial therapy should be administered for 3 to 4 weeks after drainage. Parenteral or oral therapy is frequently continued for up to a total of 6 weeks of therapy. A longer course of treatment (minimum of 6–8 weeks) may be required if the patient has accompanying osteomyelitis.
Note (4): Consider adjunctive medications including prophylactic anticonvulsants, corticosteroids, and mannitol if indicated.
  1. Osborn, Melissa K.; Steinberg, James P. (2007-01). "Subdural empyema and other suppurative complications of paranasal sinusitis". The Lancet. Infectious Diseases. 7 (1): 62–67. doi:10.1016/S1473-3099(06)70688-0. ISSN 1473-3099. PMID 17182345. Check date values in: |date= (help)