Subdural empyema causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]

Common causes of subdural empyema include Streptococci, Staphylococci, and other Gram-negative bacilli.^[1] In children, the majority of cases of subdural empyema occur due to meningitis, while in adults the most common causes are sinusitis, otitis media, mastoiditis, and trauma.^[1][2]

Subdural empyema is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in mortality or permanent disability within 24 hours if left untreated.

Intracranial subdural empyema ^[1][3][4]

The most common cause of subdural empyema in adults is the complication of an infection of the air sinuses: frontal, ethmoid, sphenoid, and maxillary. The causative organisms of the empyema are similar to those causing the infection of the sinuses. Generally multiple organisms are present in the empyema, where anaerobes are almost always an important agent.^[3][4] Common causative agents include:

• Anaerobes
• Aerobic Streptococci
  • Streptococcus milleri
  • Streptococcus anginosus
  • Streptococcus pneumoniae
• Staphylococci
• Haemophilus influenzae
• Gram-negative bacilli

Spinal Subdural Empyema ^[1][3]

• Staphylococcus aureus
• Streptococci

The most common cause of subdural empyema in children is occurs as a complication of meningitis. The agents isolated from the pus, are usually similar to the ones causing the meningitis.^[3][5] Common causative agents include:

• Haemophilus influenzae
• Streptococcus pneumoniae
• Nontyphoidal Salmonella

Common causative agents in trauma include:

• Coagulase negative strains of Staphylococcus
• Anaerobes
• Gram-negative microbes

Common causative agents in neurosurgical procedures include:

• Pseudomonas aeruginosa
• Clostridium

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