Subdural Empyema Caused by Brucellosis: A Case Report and Review of the Literature/Bruselloza Bagli Subdural Ampiyem: Bir Olgu Sunumu ve Literatur Taramasi

• Published in: Mediterranean journal of infection, microbes & antimicrobials Vol. 13S
• Main Authors: Akbulut, Bilal Bahadir, Erol, Anil, Boluk, Mustafa Serdar, Yurtseven, Taskin, Eraslan, Cenk, Arda, Bilgin, Biceroglu, Huseyin
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.01.2024
• Subjects: Brucellosis; Diagnosis; Empyema; Head injuries
• ISSN: 2147-673X; 2147-673X
• DOI: 10.4274/mjima.galenos.2024.24152.6

Neurobrucellosis is a rare and challenging complication of brucellosis. Its non-specific clinical presentation makes it challenging to diagnose. The coexistence of neurobrucellosis with subdural empyema is extremely rare, with only a few cases reported in the literature. Herein, we present the case of a 27-year-old male with a ventriculoperitoneal shunt in-situ and a history of exposure to Brucella via animal care and consumption of raw milk. The patient presented with a left frontal headache and vertigo following a head trauma. The initial cranial imaging demonstrated a left-sided subdural hematoma and slit ventricles. The patient underwent drainage by craniotomy. Brucella spp. was detected in the drained sample, and the patient was treated with a multi-modal approach, which included antibiotics and surgical drainage. The follow-up plan involved a repeat cranial computed tomography and shunt adjustment for recurrent subdural effusions. This case adds to the few reports of neurobrucellosis associated with subdural empyema. Furthermore, it highlights the importance of considering neurobrucellosis in patients with neurological symptoms and a subdural collection in brucellosis-endemic areas. Keywords: Subdural hematoma, Brucella, ventriculoperitoneal shunt, case report Norobruselloz, brusellozun nadir gorulen bir prezentasyonudur ve ozgul olmayan klinik sunumu tanisini zorlastirir. Norobrusellozun subdural ampiyem ile birlikteligi son derece nadirdir ve literaturde sadece birkac olgu bulunmaktadir. Hayvan bakimi ile ugrasan ve cig sut tuketim oykusu olan, ventrikuloperitoneal sant takili 27 yasinda bir erkek hasta, kafa travmasini takiben sol frontal bas agrisi ve bas donmesi sikayetleriyle basvurdu, ilk kraniyal goruntulemede sol tarafli subdural hematom ve slit ventrikuller goruldu. Hastaya kraniyotomi ile subdural hematom drenaji yapildi, drenaj orneginde Brucella spp. saptandi. Hastaya antibiyotikler ve cerrahi drenaj ile cok yonlu bir yaklasimla tedavi uygulandi. Takip surecinde tekrarlayan subdural efuzyonlar icin hastaya kraniyal bilgisayarli tomografi cekimleri, sant ayar degisiklikleri ve tekrarlayan cerrahi mudahaleler yapildi. Bu olgu, norobrusellozun subdural ampiyem ile birlikteligine az sayidaki orneklere katkida bulunmakta, norolojik semptomlari olan ve bruselloz-endemik bolgelerde subdural koleksiyonu olan hastalarda bu taninin goz onunde bulundurulmasinin onemini vurgulamaktadir. Anahtar Kelimeler: Subdural hematom, Brucella, ventrikuloperitoneal sant, olgu sunumu