Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2023.433
Autopsy and Case Reports
Autopsy Case Report

Fatal case of subdural empyema caused by Campylobacter rectus and Slackia exigua

Yuki Munekata; Saki Yamamoto; Shun Kato; Yutaro Kitagawa; Ken Enda; Nanase Okazaki; Satoshi Tanikawa; Zen-ichi Tanei; Yohei Ikebe; Takahiro Osawa; Soichiro Takamiya; Hideki Ujiie; Masahiro Onozawa; Satoshi Hirano; Miki Fujimura; Shinya Tanaka

Downloads: 3
Views: 532

Abstract

We report a fatal subdural empyema caused by Campylobacter rectus in a 66-year-old female who developed acute onset of confusion, dysarthria, and paresis in her left extremities. A CT scan showed hypodensity in a crescentic formation with a mild mid-line shift. She had a bruise on her forehead caused by a fall several days before admission, which initially raised subdural hematoma (SDH) diagnosis, and a burr hole procedure was planned. However, her condition deteriorated on the admission night, and she died before dawn. An autopsy revealed that she had subdural empyema (SDE) caused by Campylobacter rectus and Slackia exigua. Both microorganisms are oral microorganisms that rarely cause extra-oral infection. In our case, head trauma caused a skull bone fracture, and sinus infection might have expanded to the subdural space causing SDE. CT/MRI findings were not typical for either SDH or SDE. Early recognition of subdural empyema and prompt initiation of treatment with antibiotics and surgical drainage is essential for cases of SDE. We present our case and a review of four reported cases.

Keywords

Campylobacter rectus, Empyema, Subdural, Hematoma, Subdural, Sinusitis

References

1 Watson CPN, Camacho A. Subdural empyema mimicking subacute subdural hematoma on CT imaging. Interdiscip Neurosurg. 2018;13:92-4. http://dx.doi.org/10.1016/j.inat.2018.04.002.

2 Fernandez-de Thomas RJ, De Jesus O. Subdural Empyema. In: StatPearls. Treasure Island (FL)2022.

3 De Bonis P, Anile C, Pompucci A, Labonia M, Lucantoni C, Mangiola A. Cranial and spinal subdural empyema. Br J Neurosurg. 2009;23(3):335-40. http://dx.doi.org/10.1080/02688690902939902. PMid:19533473.

4 French H, Schaefer N, Keijzers G, Barison D, Olson S. Intracranial subdural empyema: a 10-year case series. Ochsner J. 2014;14(2):188-94. PMid:24940128.

5 Waseem M, Khan S, Bomann S. Subdural empyema complicating sinusitis. J Emerg Med. 2008;35(3):277-81. http://dx.doi.org/10.1016/j.jemermed.2007.07.019. PMid:18155385.

6 Lu HF, Yue CT, Kung WM. Salmonella Group D1 Subdural Empyema Mimicking Subdural Hematoma: A Case Report. Infect Drug Resist. 2022;15:6357-63. http://dx.doi.org/10.2147/IDR.S388101. PMid:36337934.

7 Yuan X, Shi X, Xiao H, et al. Intracranial Subdural Empyema Mimicking Chronic Subdural Hematoma. J Craniofac Surg. 2016;27(2):529-30. http://dx.doi.org/10.1097/SCS.0000000000002297. PMid:26854768.

8 Dill SR, Cobbs CG, McDonald CK. Subdural empyema: analysis of 32 cases and review. Clin Infect Dis. 1995;20(2):372-86. http://dx.doi.org/10.1093/clinids/20.2.372. PMid:7742444.

9 Chokkappan K, Lohan R. Rapidly developing subdural empyema in an adult with sinusitis: a neurosurgical threat alert. Asian J Neurosurg. 2018;13(2):458-61. http://dx.doi.org/10.4103/ajns.AJNS_97_16. PMid:29682060.

10 Wong AM, Zimmerman RA, Simon EM, Pollock AN, Bilaniuk LT. Diffusion-weighted MR imaging of subdural empyemas in children. AJNR Am J Neuroradiol. 2004;25(6):1016-21. PMid:15205140.

11 Rich PM, Deasy NP, Jarosz JM. Intracranial dural empyema. Br J Radiol. 2000;73(876):1329-36. http://dx.doi.org/10.1259/bjr.73.876.11205681. PMid:11205681.

12 Weingarten K, Zimmerman RD, Becker RD, Heier LA, Haimes AB, Deck MD. Subdural and epidural empyemas: MR imaging. AJR Am J Roentgenol. 1989;152(3):615-21. http://dx.doi.org/10.2214/ajr.152.3.615. PMid:2563623.

13 Suthar R, Sankhyan N. Bacterial Infections of the Central Nervous System. Indian J Pediatr. 2019;86(1):60-9. http://dx.doi.org/10.1007/s12098-017-2477-z. PMid:29297142.

14 Osborn MK, Steinberg JP. Subdural empyema and other suppurative complications of paranasal sinusitis. Lancet Infect Dis. 2007;7(1):62-7. http://dx.doi.org/10.1016/S1473-3099(06)70688-0. PMid:17182345.

15 Walters HL, Perloff S, Jungkind D, Measley R. A Campylobacter rectus Subdural Empyema. Infect Dis Clin Pract. 2008;16(5):332-4. http://dx.doi.org/10.1097/IPC.0b013e3181654360.

16 Lam JY, Wu AK, Ngai DC, et al. Three cases of severe invasive infections caused by Campylobacter rectus and first report of fatal C. rectus infection. J Clin Microbiol. 2011;49(4):1687-91. http://dx.doi.org/10.1128/JCM.02487-10. PMid:21270212.

17 Martiny D, Dauby N, Konopnicki D, et al. MALDI-TOF MS contribution to the diagnosis of Campylobacter rectus multiple skull base and brain abscesses. New Microbes New Infect. 2017;19:83-6. http://dx.doi.org/10.1016/j.nmni.2017.05.014. PMid:28736616.

18 Potin M, Chapuis-Taillard C, Fleisch I, et al. Subdural empyema following odontogenic infection in an elderly adult : case report about a rare case with a rare pathogen (Campylobacter rectus) and multidisciplinary favorable hospital outcome. In: 6th Spring Congress SSGIM; 2022; Monbijoustrasse. Monbijoustrasse: Swiss Society of General Internal Medicine; 2022.

19 Kawasuji H, Kaya H, Kawamura T, et al. Bacteremia caused by Slackia exigua: a report of two cases and literature review. J Infect Chemother. 2020;26(1):119-23. http://dx.doi.org/10.1016/j.jiac.2019.06.006. PMid:31300378.
 


Submitted date:
01/24/2023

Accepted date:
04/21/2023

Publication date:
05/24/2023

646e66aea953956f3355f9b3 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections