Subdural empyema causes

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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]


Life Threatening Causes

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.

Common Causes


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:

Spinal Subdural Empyema [1][3]


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:

Adults and Children

Common causative agents in trauma include:

Common causative agents in neurosurgical procedures include:

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Coagulase-negative strains of staphylococcus, Staphylococcus aureus, Staphylococcus epidermidis
Drug Side Effect No underlying causes
Ear Nose Throat A-hemolytic streptococci, Aerobic streptococci, Anaerobes, Anaerobic streptococci, Bacteroides species, Enterobacteriaceae, Klebsiella pneumoniae, Neisseria meningitidis, Otitis media, Pseudomonas aeruginosa, Sinusitis, Staphylococci, Staphylococcus aureus, Staphylococcus epidermidis
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Clostridium difficile, Enterobacteriaceae, Escherichia coli, Group-B streptococcus, Listeria monocytogenes, Nontyphoidal salmonella
Genetic No underlying causes
Hematologic Campylobacter fetus, Nonhemolytic streptococci
Iatrogenic Neurological procedures, Surgery,staphylococcus aureus, staphylococcus epidermidis
Infectious Disease Brain abscess, Epidural abscess, Mastoiditis, Meningitis
Musculoskeletal/Orthopedic No underlying causes
Neurologic Brain abscess, Epidural abscess, Mastoiditis, Meningitis, Neurological procedures, Surgery, Trauma,staphylococcus aureus, staphylococcus epidermidis, Haemophilus influenzae, Escherichia coli, streptococcus pneumoniae, Neisseria meningitidis
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Enterobacteriaceae, Group B streptococci, Listeria monocytogenes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Aerobic streptococci, Anaerobes, Coagulase-negative strains of staphylococcus, Haemophilus influenzae, Klebsiella pneumoniae, Neisseria meningitidis, Pseudomonas aeruginosa, Staphylococci, Streptococcus pneumoniae
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual Group-B streptococcus
Trauma Trauma, staphylococcus aureus, staphylococcus epidermidis, Enterobacteriaceae
Urologic No underlying causes
Miscellaneous A-hemolytic streptococci, Anaerobes, Anaerobic streptococci, Bacteroides species, Brain abscess, Campylobacter fetus, Clostridium difficile, Coagulase-negative strains of staphylococcus, Enterobacteriaceae, Epidural abscess, Escherichia coli, Gram-negative bacilli, Haemophilus influenzae, Klebsiella pneumoniae, Listeria monocytogenes, Neisseria meningitidis, Nonhemolytic streptococci, Nontyphoidal salmonella, Sinusitis, Staphylococci, Staphylococcus aureus, Staphylococcus epidermidis, Streptococci, Streptococcus anginosus, Streptococcus milleri, Streptococcus pneumoniae

Causes in Alphabetical order


  1. 1.0 1.1 1.2 1.3 Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
  2. Quraishi H, Zevallos JP (2006). "Subdural empyema as a complication of sinusitis in the pediatric population". Int. J. Pediatr. Otorhinolaryngol. 70 (9): 1581–6. doi:10.1016/j.ijporl.2006.04.007. PMID 16777239. Unknown parameter |month= ignored (help)
  3. 3.0 3.1 3.2 3.3 Greenlee JE (2003). "Subdural Empyema". Curr Treat Options Neurol. 5 (1): 13–22. PMID 12521560.
  4. 4.0 4.1 Yoshikawa TT, Chow AW, Guze LB (1975). "Role of anaerobic bacteria in subdural empyema. Report of four cases and review of 327 cases from the English literature". Am J Med. 58 (1): 99–104. PMID 234678.
  5. Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9.

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