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====[[Subdural empyema]]====
====[[Subdural empyema]]====
[[Subdural empyema]] is a life-threatening [[infection]], consisting of a localized collection of [[purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]]. Subdural empyema may be classified according to location of the infection into 2 groups: intracranial and spinal, with intracranial being the more common of the two groups, accounting for 95% of subdural empyema patients.<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> Subdural empyema accounts for approximately 15-25% of focal [[central nervous system]] [[infections]]. In 2014, the incidence of subdural empyema was estimated to be less than 1 case case per 100,000 individuals, with a male predominance.<ref name="PMC4052585">{{cite journal |vauthors=French H, Schaefer N |title=Intracranial Subdural Empyema: A 10-Year Case Series |journal=Oschner J|volume=12|issue=2 |year=2014|pmid=PMC4052585 |doi=10.1002/bip.360240911 |url=}}</ref>
The most common [[pathogens]] in intracranial subdural empyema are [[anaerobic]] and [[microaerophilic]] [[Streptococci]], compared to spinal subdural epmyema, which can be caused by either [[Streptococci]] or ''[[Staphylococcus aureus]]''.<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> If left untreated, subdural empyema frequently evolves into severe [[fever]], [[headache]], [[nausea]], [[vomiting]], [[seizures]], [[coma]], and subsequent mortality. Complications to subdural empyema include [[status epilepticus]], neurological deficits, and [[thrombosis]]. Prognosis is generally good with [[antimicrobial]] therapy. Physical examination of patients with subdural empyema is usually remarkable for [[fever]], [[facial pain]], and [[altered mental status]].<ref name="Hendaus2013">{{cite journal|last1=Hendaus|first1=Mohammed A.|title=Subdural Empyema in Children|journal=Global Journal of Health Science|volume=5|issue=6|year=2013|issn=1916-9744|doi=10.5539/gjhs.v5n6p54}}</ref><ref name="pmid23358438">{{cite journal| author=Bruner DI, Littlejohn L, Pritchard A| title=Subdural empyema presenting with seizure, confusion, and focal weakness. | journal=West J Emerg Med | year= 2012 | volume= 13 | issue= 6 | pages= 509-11 | pmid=23358438 | doi=10.5811/westjem.2012.5.11727 | pmc=PMC3555596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23358438  }} </ref><ref name=Mandell>{{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> [[MRI]] is the primary imaging study of epidural abscess, with [[CT scan]] as a secondary alternative. Treatment of subdural empyema requires a combined medical and surgical approach. In order to evacuate the pus, [[burr hole]] placement or [[craniotomy]] may be used to treat the subdural empyema. The preferred surgical mainstay of treatment for subdural empyema is [[craniotomy]].
[[Subdural empyema|Subdural]] empyema  is rare, however it may complicate one-third of all intracranial infections. Subdural empyema may follow pansinusitis, mastoiditis, orbital cellulitis and after surgery for lumbar lipomyelomeningocele manifesting with seizures, focal neurological deficits and altered mentatal status and possible progression to coma.<ref name="pmid2891793">{{cite journal| author=Miller ES, Dias PS, Uttley D| title=Management of subdural empyema: a series of 24 cases. | journal=J Neurol Neurosurg Psychiatry | year= 1987 | volume= 50 | issue= 11 | pages= 1415-8 | pmid=2891793 | doi= | pmc=1032550 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2891793  }}</ref><ref name="pmid27999711">{{cite journal| author=Yüksel MO, Gürbüz MS, Karaarslan N, Caliskan T| title=Rapidly progressing interhemispheric subdural empyema showing a three-fold increase in size within 12 hours: Case report. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 37 | pages= S872-S875 | pmid=27999711 | doi=10.4103/2152-7806.194495 | pmc=5154207 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27999711  }} </ref><ref name="pmid27898560">{{cite journal| author=Yocum D| title=Fusobacterium nucleatum: An unusual cause of subdural empyema. | journal=JAAPA | year= 2016 | volume= 29 | issue= 12 | pages= 1-4 | pmid=27898560 | doi=10.1097/01.JAA.0000508216.58368.74 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27898560  }} </ref><ref name="pmid27826090">{{cite journal| author=Guan J, Spivak ES, Wilkerson C, Park MS| title=Subdural Empyema in the Setting of Multimodal Intracranial Monitoring. | journal=World Neurosurg | year= 2016 | volume=  | issue=  | pages=  | pmid=27826090 | doi=10.1016/j.wneu.2016.10.133 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27826090  }} </ref><ref name="pmid27751703">{{cite journal| author=Byrne N, Plonsker JH, Tan LA, Byrne RW, Munoz LF| title=Orbital Cellulitis with Pansinusitis and Subdural Empyema. | journal=J Emerg Med | year= 2016 | volume=  | issue=  | pages=  | pmid=27751703 | doi=10.1016/j.jemermed.2016.05.067 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27751703  }} </ref><ref name="pmid27635411">{{cite journal| author=Pallangyo P, Lyimo F, Nicholaus P, Kain U, Janabi M| title=Spontaneous Subdural Empyema Following a High-Parasitemia Falciparum Infection in a 58-Year-Old Female From a Malaria-Endemic Region: A Case Report. | journal=J Investig Med High Impact Case Rep | year= 2016 | volume= 4 | issue= 3 | pages= 2324709616666567 | pmid=27635411 | doi=10.1177/2324709616666567 | pmc=5011302 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27635411  }} </ref><ref name="pmid27651110">{{cite journal| author=Doan N, Patel M, Nguyen HS, Mountoure A, Shabani S, Gelsomino M et al.| title=Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 9 | pages=  | pmid=27651110 | doi=10.1093/jscr/rjw158 | pmc=5029463 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27651110  }} </ref><ref name="pmid27274400">{{cite journal| author=Nguyen HS, Foy A, Havens P| title=Intracranial subdural empyema after surgery for lumbar lipomyelomeningocele: A rare complication. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 12 | pages= S301-4 | pmid=27274400 | doi=10.4103/2152-7806.182388 | pmc=4879841 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27274400  }} </ref>
[[Subdural empyema|Subdural]] empyema  is rare, however it may complicate one-third of all intracranial infections. Subdural empyema may follow pansinusitis, mastoiditis, orbital cellulitis and after surgery for lumbar lipomyelomeningocele manifesting with seizures, focal neurological deficits and altered mentatal status and possible progression to coma.<ref name="pmid2891793">{{cite journal| author=Miller ES, Dias PS, Uttley D| title=Management of subdural empyema: a series of 24 cases. | journal=J Neurol Neurosurg Psychiatry | year= 1987 | volume= 50 | issue= 11 | pages= 1415-8 | pmid=2891793 | doi= | pmc=1032550 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2891793  }}</ref><ref name="pmid27999711">{{cite journal| author=Yüksel MO, Gürbüz MS, Karaarslan N, Caliskan T| title=Rapidly progressing interhemispheric subdural empyema showing a three-fold increase in size within 12 hours: Case report. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 37 | pages= S872-S875 | pmid=27999711 | doi=10.4103/2152-7806.194495 | pmc=5154207 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27999711  }} </ref><ref name="pmid27898560">{{cite journal| author=Yocum D| title=Fusobacterium nucleatum: An unusual cause of subdural empyema. | journal=JAAPA | year= 2016 | volume= 29 | issue= 12 | pages= 1-4 | pmid=27898560 | doi=10.1097/01.JAA.0000508216.58368.74 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27898560  }} </ref><ref name="pmid27826090">{{cite journal| author=Guan J, Spivak ES, Wilkerson C, Park MS| title=Subdural Empyema in the Setting of Multimodal Intracranial Monitoring. | journal=World Neurosurg | year= 2016 | volume=  | issue=  | pages=  | pmid=27826090 | doi=10.1016/j.wneu.2016.10.133 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27826090  }} </ref><ref name="pmid27751703">{{cite journal| author=Byrne N, Plonsker JH, Tan LA, Byrne RW, Munoz LF| title=Orbital Cellulitis with Pansinusitis and Subdural Empyema. | journal=J Emerg Med | year= 2016 | volume=  | issue=  | pages=  | pmid=27751703 | doi=10.1016/j.jemermed.2016.05.067 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27751703  }} </ref><ref name="pmid27635411">{{cite journal| author=Pallangyo P, Lyimo F, Nicholaus P, Kain U, Janabi M| title=Spontaneous Subdural Empyema Following a High-Parasitemia Falciparum Infection in a 58-Year-Old Female From a Malaria-Endemic Region: A Case Report. | journal=J Investig Med High Impact Case Rep | year= 2016 | volume= 4 | issue= 3 | pages= 2324709616666567 | pmid=27635411 | doi=10.1177/2324709616666567 | pmc=5011302 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27635411  }} </ref><ref name="pmid27651110">{{cite journal| author=Doan N, Patel M, Nguyen HS, Mountoure A, Shabani S, Gelsomino M et al.| title=Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma. | journal=J Surg Case Rep | year= 2016 | volume= 2016 | issue= 9 | pages=  | pmid=27651110 | doi=10.1093/jscr/rjw158 | pmc=5029463 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27651110  }} </ref><ref name="pmid27274400">{{cite journal| author=Nguyen HS, Foy A, Havens P| title=Intracranial subdural empyema after surgery for lumbar lipomyelomeningocele: A rare complication. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 12 | pages= S301-4 | pmid=27274400 | doi=10.4103/2152-7806.182388 | pmc=4879841 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27274400  }} </ref>


Revision as of 21:10, 16 January 2017

Empyema Microchapters

Patient Information

Overview

Classification

Subdural empyema
Pleural empyema

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Empyema classification

Classification by organ system or location of empyema

Pleural empyema

This is also called empyema thoracis. Thoracic empyema arises from an infection within the lung, often associated with parapneumonic effusions. Parapneumonic effusions may be uncomplicated or complicated effusions. Complicated parapneumonic effusion results when bacteria invade the pleural space with a resultant formation of an empyema thoracis.

Gallbladder empyema

Gallbladder empyema is also called suppurative cholecystitis which may complicate acute/chronic cholecystitis whereby pus collects in the gall bladder lumen. It is common in people with diabetes and atherosclerotic disease.[1][2]

Normally results from an obstruction of the cystic duct hampering drainage of bile from the gall bladder which becomes secondarily infected.

Subdural empyema

Subdural empyema is a life-threatening infection, consisting of a localized collection of purulent material, usually unilateral, between the dura mater and the arachnoid mater. Subdural empyema may be classified according to location of the infection into 2 groups: intracranial and spinal, with intracranial being the more common of the two groups, accounting for 95% of subdural empyema patients.[3][4] Subdural empyema accounts for approximately 15-25% of focal central nervous system infections. In 2014, the incidence of subdural empyema was estimated to be less than 1 case case per 100,000 individuals, with a male predominance.[5] The most common pathogens in intracranial subdural empyema are anaerobic and microaerophilic Streptococci, compared to spinal subdural epmyema, which can be caused by either Streptococci or Staphylococcus aureus.[4] If left untreated, subdural empyema frequently evolves into severe fever, headache, nausea, vomiting, seizures, coma, and subsequent mortality. Complications to subdural empyema include status epilepticus, neurological deficits, and thrombosis. Prognosis is generally good with antimicrobial therapy. Physical examination of patients with subdural empyema is usually remarkable for fever, facial pain, and altered mental status.[6][7][8] MRI is the primary imaging study of epidural abscess, with CT scan as a secondary alternative. Treatment of subdural empyema requires a combined medical and surgical approach. In order to evacuate the pus, burr hole placement or craniotomy may be used to treat the subdural empyema. The preferred surgical mainstay of treatment for subdural empyema is craniotomy.

Subdural empyema  is rare, however it may complicate one-third of all intracranial infections. Subdural empyema may follow pansinusitis, mastoiditis, orbital cellulitis and after surgery for lumbar lipomyelomeningocele manifesting with seizures, focal neurological deficits and altered mentatal status and possible progression to coma.[9][10][11][12][13][14][15][16]

Joint empyema

This usually occurs after superimposed infection of the sinovial fluid following some procedures example post-lumbar or sacroiliac discectomy and instrumentation or surgery.[17][18][19]

Empyema cystitis

This type of empyema may complicate a dysfunctional[20][21] or an obstructed[22] urinary bladder. Empyema cystis may be treated by intermittent self-catherterization[23] or vaginal vesicostomy for empyema of dysfunctional bladder[24]

References

  1. ↑ Watanabe Y, Nagayama M, Okumura A, Amoh Y, Katsube T, Suga T; et al. (2007). "MR imaging of acute biliary disorders". Radiographics. 27 (2): 477–95. doi:10.1148/rg.272055148. PMID 17374864.
  2. ↑ O'Connor OJ, Maher MM (2011). "Imaging of cholecystitis". AJR Am J Roentgenol. 196 (4): W367–74. doi:10.2214/AJR.10.4340. PMID 21427298.
  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.
  4. ↑ 4.0 4.1 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.
  5. ↑ French H, Schaefer N (2014). "Intracranial Subdural Empyema: A 10-Year Case Series". Oschner J. 12 (2). doi:10.1002/bip.360240911. PMID PMC4052585 Check |pmid= value (help).
  6. ↑ Hendaus, Mohammed A. (2013). "Subdural Empyema in Children". Global Journal of Health Science. 5 (6). doi:10.5539/gjhs.v5n6p54. ISSN 1916-9744.
  7. ↑ Bruner DI, Littlejohn L, Pritchard A (2012). "Subdural empyema presenting with seizure, confusion, and focal weakness". West J Emerg Med. 13 (6): 509–11. doi:10.5811/westjem.2012.5.11727. PMC 3555596. PMID 23358438.
  8. ↑ 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.
  9. ↑ Miller ES, Dias PS, Uttley D (1987). "Management of subdural empyema: a series of 24 cases". J Neurol Neurosurg Psychiatry. 50 (11): 1415–8. PMC 1032550. PMID 2891793.
  10. ↑ Yüksel MO, Gürbüz MS, Karaarslan N, Caliskan T (2016). "Rapidly progressing interhemispheric subdural empyema showing a three-fold increase in size within 12 hours: Case report". Surg Neurol Int. 7 (Suppl 37): S872–S875. doi:10.4103/2152-7806.194495. PMC 5154207. PMID 27999711.
  11. ↑ Yocum D (2016). "Fusobacterium nucleatum: An unusual cause of subdural empyema". JAAPA. 29 (12): 1–4. doi:10.1097/01.JAA.0000508216.58368.74. PMID 27898560.
  12. ↑ Guan J, Spivak ES, Wilkerson C, Park MS (2016). "Subdural Empyema in the Setting of Multimodal Intracranial Monitoring". World Neurosurg. doi:10.1016/j.wneu.2016.10.133. PMID 27826090.
  13. ↑ Byrne N, Plonsker JH, Tan LA, Byrne RW, Munoz LF (2016). "Orbital Cellulitis with Pansinusitis and Subdural Empyema". J Emerg Med. doi:10.1016/j.jemermed.2016.05.067. PMID 27751703.
  14. ↑ Pallangyo P, Lyimo F, Nicholaus P, Kain U, Janabi M (2016). "Spontaneous Subdural Empyema Following a High-Parasitemia Falciparum Infection in a 58-Year-Old Female From a Malaria-Endemic Region: A Case Report". J Investig Med High Impact Case Rep. 4 (3): 2324709616666567. doi:10.1177/2324709616666567. PMC 5011302. PMID 27635411.
  15. ↑ Doan N, Patel M, Nguyen HS, Mountoure A, Shabani S, Gelsomino M; et al. (2016). "Intracranial subdural empyema mimicking a recurrent chronic subdural hematoma". J Surg Case Rep. 2016 (9). doi:10.1093/jscr/rjw158. PMC 5029463. PMID 27651110.
  16. ↑ Nguyen HS, Foy A, Havens P (2016). "Intracranial subdural empyema after surgery for lumbar lipomyelomeningocele: A rare complication". Surg Neurol Int. 7 (Suppl 12): S301–4. doi:10.4103/2152-7806.182388. PMC 4879841. PMID 27274400.
  17. ↑ Bayraktutan U, Sade R, Kantarci M (2016). "Septic arthritis and empyema of the sacroiliac joint after lumbar discectomy and instrumentation". Spine J. 16 (7): e417–8. doi:10.1016/j.spinee.2015.12.033. PMID 26769350.
  18. ↑ Schneider MM, Preiss S, Harder LP, Salzmann GM (2015). "[Destructive chondrolysis following intraarticular application of lavasorb (polihexanid) for treatment of knee empyema]". MMW Fortschr Med. 157 (8): 47–8. doi:10.1007/s15006-015-3033-2. PMID 26012684.
  19. ↑ Oheim R, Gille J, Schoop R, Badih S, Grimme CH, Schulz AP; et al. (2014). "Surgical therapy of extensive knee joint empyema: mid-term results after two-stage versus one-stage procedures". Knee Surg Sports Traumatol Arthrosc. 22 (12): 3150–6. doi:10.1007/s00167-013-2754-y. PMID 24217715.
  20. ↑ Min Z (2014). "A forgotten complication of a defunctionalized urinary bladder: pyocystis". Intern Emerg Med. 9 (6): 691–2. doi:10.1007/s11739-014-1060-0. PMID 24554081.
  21. ↑ Szkodny A, Przybyla J (1975). "[Bladder empyema]". Pol Przegl Chir. 47 (2A): 301–2. PMID 1118412.
  22. ↑ Sharon V, Kimche D, Kende L (1973). "[Empyema of the obstructed urinary bladder]". Harefuah. 84 (2): 75–7. PMID 4704614.
  23. ↑ Herwig KR (1975). "Empyema cystis treated by intermittent self-catherterization". J Urol. 113 (5): 719. PMID 1168734.
  24. ↑ Spence HM, Allen TD (1971). "Vaginal vesicostomy for empyema of the defunctionalized bladder". J Urol. 106 (6): 862–4. PMID 5116304.

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