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Subdural empyema in bacterial meningitis Neurol 79:2133-2139, Jim, K.,et al, 2012 See this aricle in Pubmed Article Abstract Although rare, subdural empyema must be considered in patients with community-acquired bacterial meningitis and otitis or sinusitis, focal neurologic deficits, or epileptic seizures. S pneumoniae is the predominant causative organism and neurosurgical intervention should be regarded as first-choice therapy in patients with empyema causing midline shift and focal neurologic abnormalities or a decreased level of consciousness.

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