Uncommon Pathogen Bacillus Cereus Causing Subdural Empyema in a Child

Abstract

BACKGROUND: Subdural empyema (SDE) in children is a severeintracranial infection. Many pathogens can cause SDE.CASE DETAILS: In this articlewe present a 15-month oldIndonesian boy diagnosed as SDE based on the clinical symptomsand neuroimaging. A complete blood count showed white blood cellcount of 13.800/mm 3 and the CRP level was 8.3 mg/L. Craniotomyfollowing burr hole drainage procedure was performed to decreaseintracranial pressure. The liquor culture indicated Bacillus cereus.A meropenem injection and metronidazole infusion wereadministered appropriately with antibiotic sensitivity for severalweeks. Immediate initiation of appropriate antibiotic therapyrelated to an accelerated surgical drainage can improve theoutcome.CONCLUSION: The combination of medication and surgerytreatment for Bacillus cereus in SDE resulted in a good response,leaving neurological sequelae.