INFECTED SUBDURAL-HEMATOMA

A case is presented in which Escherichia coli seeded a pre-existing ch ronic subdural hematoma. A 77-year-old woman was admitted to our hospi tal because of lethargy, left hemiparesis and fever. Drainage through a burr hole hole was performed with the diagnosis of bilateral chronic subdural hematoma. Operative findings revealed the infected subdural hematoma on the right side and non-infected subdural hematoma on the l eft side. Cultures of the subdural hematoma grew Escherichia coli. In view of the pyuria, the etiology of the infected subdural hematoma was postulated to be a urinary tract infection. In the majority of 14 rep orted cases, the causative organisms were Escherichia coli, Salmonella , and the systemic sources of infection included the urinary tract, ga strointestinal disease, or were unknown. The possibility of infected s ubdural hematoma should be considered when computed tomography finding s suggestive of chronic subdural hematoma exist in a patient with sign s of infection. (C) Harcourt Brace & Co. Ltd 1998.