Spontaneous subdural empyema in falciparum malaria: a case study.

CLINICAL HISTORY: Malaria is one of the most common diseases in the tropical countries. Cerebral malaria is usually a diffuse symmetric encephalopathy with focal signs being unusual.

METHODS: We present a three-year old girl lapsing into unconsciousness following a seizure while undergoing treatment for malaria. Imaging revealed a large heterogenous density, left hemispheric acute subdural haematoma with brain herniation. Investigations revealed anaemia, thrombocytopenia and positive peripheral blood smear for falciparum malaria.

RESULTS: Treatment involved surgical evacuation of the clot and the associated subdural empyema, intravenous quinine and antibiotics.

CONCLUSION: This is the second case report of spontaneous subdural empyema in complicated falciparum malaria and highlights a rare but surgically manageable complication.