ArticleIDCases2026
Diagnosis and management of subdural empyema with negative cultures: The value of magnetic resonance imaging and early surgical.
Article in IDCases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
Funding
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Abstract
Background: Subdural empyema (SDE) is a neurosurgical emergency with 6-15% mortality. Culture-negative cases pose significant diagnostic and therapeutic challenges. Case presentation: A 51-year-old male with chronic alcohol abuse presented with high fever (39°C), severe headache, meningismus, and altered mental status (GCS 13). CSF analysis revealed protein 28 g/L (60-fold elevated), uncountable cells due to viscous fluid, and Gram-positive cocci. Initial non-contrast CT suggested chronic subdural hematoma, but surgical exploration revealed frontal subdural empyema with frank purulent discharge. All cultures (pus, CSF, blood, urine) were negative despite elevated inflammatory markers (CRP 303 mg/L, PCT 2.12 ng/mL, WBC 16.7 × 10⁹/L). Treatment with surgical drainage and combination antibiotics (meropenem with linezolid) achieved complete recovery after 24 days. Conclusion: This case emphasizes the diagnostic challenges of distinguishing subdural hemorrhage from empyema on a CT scanner, the critical importance of early surgical intervention, and the necessity of broad-spectrum empirical antibiotics, with consideration of molecular diagnostics when cultures are negative.
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