# Spinal Subdural Empyema Successfully Treated With Conservative Therapy: A Case Report

## TL;DR

A patient with spinal subdural empyema was successfully treated with antibiotics instead of surgery, avoiding complications.

## Contribution

This case report demonstrates that conservative therapy can be effective for subdural empyema in specific cases.

## Key findings

- A 51-year-old woman with spinal subdural empyema was successfully treated with conservative antibiotic therapy.
- MRI showed two dural tears, suggesting that multiple tears may allow for non-surgical treatment.
- The patient was discharged without neurological complications, indicating success of conservative management.

## Abstract

A 51-year-old woman presented to our hospital with septic shock. Magnetic resonance imaging (MRI) revealed a spinal epidural abscess and a spinal subdural empyema (SSE). Surgery in the prone position was considered impossible because of the patient’s recent history of cardiac surgery. Therefore, the patient was treated conservatively with antibiotics. Treatment was successful, and the patient was discharged without any neurological complications. Because of its high risk of mortality, subdural empyema is almost always treated by surgery. However, we have encountered a case in which conservative management alone was successful. Magnetic resonance images revealed two areas of dural tear. Patients with multiple tears may be candidates for conservative therapy.