Salmonella Group D1 Subdural Empyema Mimicking Subdural Hematoma: A Case Report

Figures & data

Table 1 Summary of Reported Cases of Salmonella Group D Subdural Empyema

Publication	Age (years)/Gender	Year/Author	Risk Factor	Symptoms	Causative Organism	Surgery
1	0.5/Male	1998/K C Jain et al^Citation20	Young age	Fever, vomiting, increasing head size	Salmonella typhi	Burr hole
2	0.8~56/All five patients were male	2002/A K Mahapatra et al^Citation21	Patients enrolled from third world	Fever, seizure, weakness, impaired cognition, papilledema, increasing head size	Salmonella typhi Salmonella group D	Burr hole
3	37/Male	1997/L Aliaga et al^Citation22	Human immunodeficiency virus	Fever, headache	Salmonella enteritidis	Craniotomy
4	49/Male	1986/L Grosinger et al^Citation23	Lung squamous cell carcinoma	Fever, weakness, homonymous hemianopsia	Salmonella dublin	Craniotomy
5	63/Female	1995/P J Parker et al^Citation24	Human immunodeficiency virus	Fever, weakness, impaired cognition, weight loss, diarrhea	Salmonella dublin	Craniotomy
6	64/Male	1998/M Kan et al^Citation25	Myelodysplastic syndrome	Fever, seizure, impaired cognition, anisocoria	Salmonella enteritidis	Burr hole Craniotomy
7	66/Male	2000/M J Chandy^Citation26	Patient enrolled from third world	Fever, headache, weakness, seizure, impaired cognition, papilledema	Salmonella group D	Burr hole

Figure 1 Neuroimaging studies of a 58-year-old male patient with Salmonella subdural empyema. (A) Axial computed tomography showing massive right convexity subdural fluid collection (white arrows) with midline shift at emergency department. (B) Axial T1-weighted magnetic resonance imaging showing thick residual subdural fluid collection (white arrows) with rim enhancement 4 days postoperatively. (C) Axial T1-weighted magnetic resonance imaging showing significantly reduced subdural empyema (white arrows) with improved midline shift before discharge. (D) Axial T1-weighted magnetic resonance imaging showing vanishing subdural empyema without midline shift after more than 5 years follow-up.

Figure 2 Intraoperative burr hole drainage gross photograph showing large amount of brown-yellow pus in subdural space.

Figure 3 Histopathological photomicrograph: Papanicolaou stain, magnification ×200 showing numerous neutrophils with abundant background amorphous necrotic material, compatible with pus/abscess.

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Data Sharing Statement

All clinical and other information is available in the patient’s medical record in the Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation.