We report our clinical experience with a patient who intially had marginal periodontitis, which progressed to peritonsillitis and subdural empyema.
The patient was a 57-year-old woman. On June 16, she visited our department. The diagnosis of peritonsillitis originating in 6 was made at our department. Chemotherapy was given and the pus was discharged by incision. The deeply spreading abscess and the presence of headache before surgery suggested that the inflammation extended into the head. A computed tomographic scan revealed that the left side parieto-occipital lobe had an abnormal appearance. After consultation with the department of neurosurgery, Nihon University, School of Medicine, a diagnosis of subdural empyema was established. The patient was transferred to the department of neurosurgery, and drainage by craniotomy was carried out on June 20. The pathogens were shown to be Streptococcus constellatus and Bacteroides mellaninogenicus group. On July 4, surgery was agein performed to create a path for drainage. A magnetic resonance imaging scan showed no evidence of the abscess on July 18, and the drain was removed. On August 19, the patient was discharged because symptoms had improved.
