Advancements in Case Studies
Case Report-Subdural Empyema as
a Life-threatening Complication of
Submission:August 01, 2022; Published: August 08, 2022
ISSN 2639-0531Volume3 Issue4
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Sinusitis is a prevalent, typically benign condition, yet uncommon but severe complications,
including intracranial infection and death, may occur if cases go unrecognized and are not promptly
and appropriately treated. This report presents a rare case of acute sinusitis that ultimately resulted in
subdural empyema and death in a 22-year-old woman.
A 22-year-old woman initially presented to the emergency department with acute
onset of headache and fever. Workup revealed pyogenic meningitis, likely secondary to acute sinusitis.
Her condition quickly deteriorated with repeated seizures requiring continuous EEG monitoring. MRI
revealed findings compatible with acute bilateral frontal subdural empyema. The patient underwent
endoscopic sinus surgery with image guidance for drainage of the empyema. The patient became apneic
shortly after the surgical procedure; a repeat CT revealed diffuse cerebral edema and she died despite
external ventricular drainage.
Though common and mostly benign, acute sinusitis can lead to disastrous outcomes if
the infection spreads to adjacent structures and becomes an intracranial process. Progression can be
rapid. Management typically involves broad-spectrum antibiotics as well as surgical debridement and
intervention. Subdural empyema, a rare complication of sinusitis, should be suspected if there is clinical
evidence of mental status change, meningeal signs, focal neurological findings, or seizures. Interventions,
including medications, the timing of surgery, and surgical approach, need to be optimized via collaborative
efforts of all physicians and surgeons involved in caring for the patient. A high index of suspicion is the
first step in arriving at a correct diagnosis to improve patient outcomes.
Keywords:Sinusitis; Bacterial sinusitis; Meningitis; Empyema; Subdural empyema; Case report