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Yu-Lung Hsu, Hsiao-Chuan Lin, Yu-Tzu Chang, Hsiang-Ming Huang, Tsung-Hsueh Hsieh, Ting-Yu Yen, Hsiu-Mei Wei and Kao-Pin Hwang
Hematogenous dissemination from a localized infection to a previous existing subdural hematoma is an extremely rare cause of subdural empyema which is termed infected subdural hematoma. We reported a 5-month-old male infant suffered from infected subdural hematoma by Escherichia coli (E. coli). In this patient, urinary tract infection was the most favorable origin from which seed the organism to subdural space hematogenously with evidence of pyuria and pyelonephritis. Subdural empyema was well treated after burr hole drainage with adequate antibiotic use. This infant is now doing well based on findings from regular outpatient followed-up without recurrence of infection and sequela. In conclusion, the applicable treatment strategy for infected subdural hematoma has not been determined due to its rarity. However, adequate drainage and duration of antibiotic use will be related to achieving a more satisfactory outcome when compared with subdural empyema associated with meningitis.