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July 1980

Hematogenous Infection of Subdural Hematoma

Author Affiliations

St Luke's Hospital Center New York

Arch Neurol. 1980;37(7):467-468. doi:10.1001/archneur.1980.00500560097024

To the Editor.—  Kaufman and Hilaire, in their article "Salmonella Meningitis" (36:578-580, 1979), speculated that trauma to the nervous system prior to asymptomatic bacteremia led to Salmonella infection of the meninges. These authors noted that a similar postulate was considered in two cases of Salmonella-infected subdural hematoma.1.2This concept of "locus minoris resistentiae" is illustrated by a subdural hematoma invaded by a blood-borne organism from the urinary tract.

Report of a Case.—  A 77-year-old woman was admitted with headache and right-sided weakness of one day's duration, following three weeks of general weakness.The patient was febrile to 38.9 °C and pale. A mass was felt in the right lower abdomen. She was lethargic with nonfluent dysphasia, right homonymous hemianopsia, and flaccid right hemiplegia. The hemoglobin level was 4.4 g/dL. The WBC count was 10,300/cu mm, with normal differential cell count. Urinalysis demonstrated 20 to 50 WBCs per

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