Hematogenous Infection of Subdural Hematoma

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. 1.2 This 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