Severe herpetic encephalitis in an African schoolchild: case report

• Acosta Herrería, Dulvis Lianet ^[3] ; Santana Pérez, Jorge Luis ^[1] ; Sosa Remón, Ariel ^[2] ; Auza-Santivañez, Jhossmar Cristians ; Jeréz Alvarez, Ana Esperanza ^[2] ; Santana León, Jorge Luis ^[4] ; Apaza-Huanca, Blas ^[5]
  1. [1] Universidad de Ciencias Medicas

     Universidad de Ciencias Medicas

     Hospital, Costa Rica

     
  2. [2] Universidad de Ciencias Médicas de la Habana

     Universidad de Ciencias Médicas de la Habana

     Cuba

     
  3. [3] Universidad de Ciencias Médicas de Granma, Cuba. Centro Hospitalario Universitario Peltier. Djibouti
  4. [4] Universidad de Ciencias Médicas de Ciego de Ávila. Estudiante de Medicina. Cuba
  5. [5] Ministerio de Salud y Deportes. La Paz, Bolivia

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• Localización: AG Salud, ISSN-e 3006-6859, Vol. 3, Nº. 0, 2025 (Ejemplar dedicado a: AG Salud)
• Idioma: inglés
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  • Introduction: Subdural empyema (ESD) is a collection of pus between the dura mater and arachnoid, and constitutes a medical emergency due to its rapid progression and high mortality rate. Although ENT infections are the main causes, odontogenic infections can also lead to ESD. Early diagnosis, intravenous antibiotic therapy and surgical intervention are essential to reduce mortality.Clinical case: A 32-year-old male patient presented with a month-long picture of swelling and pain on the left side of the face, recently aggravated by fever, headache, vomiting and generalised tonic-clonic convulsions. He had a history of alcoholism and recurrent dental infections. Imaging revealed a bilateral subdural empyema with left-sided predominance. Urgent antibiotic treatment was initiated, followed by bilateral craniotomy and drainage of purulent material. In addition, a brain abscess and a subgaleal haematoma were managed. Cultures identified Streptococcus viridans and coagulase-negative Staphylococcus, with good response to targeted therapy. The patient progressed favourably and was discharged in good condition.Conclusions: In regions like Bolivia, the prevalence of odontogenic infections due to cultural and economic factors increases the risk of severe complications such as SDE. A multidisciplinary approach, including early diagnosis, broad-spectrum antibiotics, and surgical intervention, is essential to improve outcomes and reduce mortality in these patients