Massive subdural empyema secondary to infectious parotitis: a case report

Background: Subdural empyema is an intracranial focal collection of purulent material between the dura and arachnoid mater. The most common causes are purulent meningitis in infants and sinusitis and otitis media in older children through a direct extension of the infection. Although it is very rare, parotitis may also cause subdural empyema. This report presents our case of subdural empyema due to infectious parotitis in a pediatric patient.
Case report: A 1-year-old boy was referred from other hospitals for multiple seizure episodes. He also had a complaint of vomit and fever 3 weeks ago. On the neurological examination, we found that he had a GCS of 8, no meningeal sign was found, and with dilated pupil on the right side. A contrast-enhanced head computed tomography (CT) scan revealed multiple hypodense masses with ring enhancement over the right hemisphere, and a severe midline shift suggested as subdural empyema. We then performed a craniotomy to evacuate the empyema. Two weeks after surgery, he was fully alert without any surgical morbidity.
Conclusion: Although parotitis is the less likely disease that can cause subdural empyema, we should also include the disease as the possible cause before we examine the patient more thoroughly and exclude them as the disease that can cause subdural empyema.