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Case Reports in Medicine
Volume 2015, Article ID 931819, 3 pages
http://dx.doi.org/10.1155/2015/931819
Case Report

Subdural Empyema Complicating Bacterial Meningitis: A Challenging Diagnosis in a Patient with Polysubstance Abuse

Department of Medicine, University of Florida, 653 W. 8th Street, Box L18, Jacksonville, FL 32209, USA

Received 28 June 2015; Revised 17 September 2015; Accepted 27 September 2015

Academic Editor: Di Lazzaro Vincenzo

Copyright © 2015 Melissa Dakkak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Subdural empyema (SDE) and cerebrovascular accident (CVA) are uncommon life-threatening complications of bacterial meningitis, which require urgent neurosurgical intervention to prevent adverse outcomes. Clinicians must be vigilant of the onset of focal neurologic deficits or seizure activity to establish the diagnosis of SDE. Streptococcus pneumoniae accounts for <1% of pyogenic brain abscesses. This case describes a presentation of community acquired pneumococcal pneumonia in which the diagnosis of SDE with vasculitis induced CVA was confounded by concomitant substance abuse and sedation.