A collection of pus (infected fluid) beneath the outer membrane covering of the brain (called the dura) that can follow aggressive forms of bacterial meningitis .

Causes, incidence, and risk factors

A subdural effusion is a rare complication of bacterial meningitis . Subdural effusion is more common in meningitis caused by Hemophilus influenza and in infants. Some signs are similar to those of meningitis but these follow the disease rather than accompany it. In infants, signs include fever, lethargy, bulging fontanelle, separated sutures, and increasing head circumference. The effusion may cause fever to persist past the expected time after antibiotic treatment. Increased pressure can cause lethargy, vomiting and seizures .

Signs and tests

There is often a history of recent bacterial meningitis . Tests:

Treatment

Surgical drainage of the effusion is often necessary. Treatment with intravenous antibiotics is also required.

Expectations (prognosis)

Full recovery from the effusion is expected. If there are lasting neurological problems these are generally caused by the meningitis not the effusion. Extended use of antibiotic therapy is usually necessary.

Complications

Complications from surgery include bleeding, infection and damage to underlying brain structures which can result in a tempporary or permanent neurologic deficit. Seizures may occur after bacterial meningitis and may need prolonged treatment with medications.

Calling your health care provider

Call your health care provider if your child has recently been treated for meningitis and symptoms persist, or if new symptoms such as those listed above develop.

Prevention

This may be an unavoidable complication of bacterial meningitis , even when the meningitis is treated aggressively with intravenous antibiotics.