A 20-year-old male patient was admitted to this hospital because of headache and high fever on October 10, 1974.
He has insidiously developed frontal headache and high fever for these 10 days, followed by vomiting, convulsions, aphasia and motor weakness on the left extremities and subsequently fell into semicomatose state. Hemogram showed marked letikocytosis, 22500/mm3, and cerebrospinal fluid cell count revealed increased leukocyte, 1210/n:m3.
Simple skull Roentgenograms showed no significant abnormalities except for suspicious haziness on the left frontal sinus.
Carotid angiogram showed distal shift of the anterior cerebral artery, medial displacement of the middle cerebral artery and small avascular area on the left temporo-parietal area. Brain scan showed high activities on the entire left cerebral hemisphere. On October 12,1974 a large fronto-temporo-parietal osteoplastic cranictcmy was, done. Yellowish green, foul cdored pus gushed out from the subdural space of the entier operating fields. Proteus mirabilis was isolated in pus culture.
He was discharged with good recovery two months later.
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