Subdural Empyema in Pediatric Bacterial Meningitis: A Case Report

Abstract

Bacterial meningitis in pediatric populations presents a formidable challenge, necessitating careful evaluation and swift intervention. The clinical spectrum of pediatric bacterial meningitis requires a clear understanding, considering its diverse presentations, risk factors, and evolving diagnostic and therapeutic approaches. We present the case of an eight-year-old male who presented with an acute onset of fever, severe headache, and vomiting following an upper respiratory tract infection. A physical examination revealed meningeal irritation signs, altered consciousness, and focal seizures. Laboratory results showed elevated inflammatory markers, and cerebrospinal fluid analysis indicated abnormalities. Initial imaging displayed sinus involvement, but the patient's condition deteriorated. Subsequent magnetic resonance imaging revealed subdural empyema and meningoencephalitis. Streptococcus pneumoniae was identified as the causative agent. Subsequently, tailored antibiotic therapy and urgent neurosurgical interventions were initiated. The patient recovered with the resolution of neurological deficits. This case underscores the complexity of pediatric bacterial meningitis and its potential complications, emphasizing the relationship between upper respiratory tract infections, sinus involvement, and meningitis development. A multidisciplinary approach, combining targeted antimicrobial therapy with neurosurgical intervention, proved crucial for optimal management and favorable outcomes. This detailed case report highlights the importance of early diagnosis and comprehensive management in pediatric bacterial meningitis cases.