Intramedullary spinal cord abscess: The result of a missed congenital dermal sinus

Kanaheswari, Y; Lai, C. J.; Lope, Raja Juanita Raja; Bakar, Azizi Abu; Zulfiqar, Mazahir

doi:10.1111/jpc.12707

Cited by 16 publications

(16 citation statements)

References 5 publications

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“…While IMA may be seen at any age it is most often seen in children below the age of 5 years [6]. Diagnosis is difficult and may be delayed until the development of neurological deficits [4,6]. Progressive sensory and motor losses are the most commonly seen findings of IMA.…”

Section: Discussionmentioning

confidence: 99%

“…The most frequently seen complication in CSDS patients is meningitis and the least seen but most severe complication is intramedullary abscess (IMA) (1). While IMA may be seen at any age it is most often seen in children below the age of 5 years [6]. Diagnosis is difficult and may be delayed until the development of neurological deficits [4,6].…”

Section: Discussionmentioning

confidence: 99%

“…However, the gold standard in imaging is MRI (6). Early stage excision of dermal sinus tracts determined with physical examination and imaging methods may prevent the development of progressive and destructive infections in the patient (4).…”

Section: Discussionmentioning

confidence: 99%

“…Dermal sinus infection as a result of this may cause dramatic outcomes such as paraplegia and myelitis [5]. To determine the underlying spinal pathologies of these midline skin symptoms and to prevent neurological damage which may occur associated with these, there must be referral to imaging methods [6]. The case is here presented of an infant whose parents noticed a red mark in the lumbar region from birth and a sacral dimple.…”

Section: Introductionmentioning

confidence: 99%

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Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Altun¹,

Yüksel²

2017

Pau Med J

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Dermal sinus is a type of spina bifida occulta which develops as a result of incomplete separation of the cutaneous ectoderm from the underlying neural ectoderm. It generally has sacral location and may be accompanied by colour change, increased hairiness and sacral dimple. In half of cases the sinus may be associated with the spinal canal. Dermal sinus infection as a result of this may cause dramatic outcomes such as paraplegia and myelitis. The case is here presented of an 18-month old female infant who had started a fever 40 days previously, was taken to a doctor and treatment of antibiotics and antipyretics was started for a diagnosis of pharyngitis but the high fever continued despite the treatment. After 20 days, redness and swelling on the back was noticed together with the fever and as there was a yellow-coloured discharge from the area of the swelling, the doctor was again consulted and the antibiotics were changed. The patient was then brought to our clinic, as in the previous 3 days, there had been increasingly reduced movement of the feet. As a result of tests applied to the patient, intramedullary abscess was determined. In neonates and infants, the spinal area must be evaluated well. It must be kept in mind that in patients with colour change, increased hair and especially sacral dimple, there could be midline closure defects. Pam Med J 2017;10(2):188-191Key words: Dermal sinus, Sacral dimple, Abscess, Early diagnosis. ÖzetDermal sinus, spina bifida occultanin bir tipi olup kütanöz ektoderm ile altinda bulunan nöral ektodermin ayrilmasinin tamamlanamamasi sonucu gelişir.Genellikle sakral yerleşimlidir ve ciltte renk değişikliği, killanma artişi,sakral gamze eşlik edebilir. Olgularin yarisinda sinüs spinal kanal ile ilişkili olabilir. Bunun sonucu olarak dermal sinüs enfeksiyonu, parepleji, myelit gibi dramatik sonuçlara neden olabilir. Bir buçuk yaşinda kiz hasta 40 gün öncesinde ateşi başlamiş ve başvurduğu doktor tarafindan farenjit tanisiyla antibiyotik ve ateş düşürücü tedavisi başlanmiş ancak tedaviye rağmen ateş yüksekliği devam etmiş. Yirmi gün önce ateş yüksekliği ile birlikte sirtinda kizariklik ve şişlik fark edilmiş ve şişlik yerinden sari renkli akinti gelmesi üzerine tekrar başvurduğu doktor tarafindan antibiyotiği değiştirilmiş. Son üç gündür giderek artan ayak hareketlerinde azalma nedeniyle kliniğimize başvuran ve yapilan tetkikler sonucu intramedüller apse tespit edilen hasta sunuldu. Yenidoğan dönemindeki hastalarda spinal bölge iyi değerlendirilmeli, renk değişikliği, killanma artişi ve özellikle sakral gamzesi olan hastalarda orta hat kapanma defektleri olabileceği akilda tutulmalidir. Derg 2017;(2):188-191 Pam Tıp

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Altun¹,

Yüksel²

2017

Pau Med J

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“…4 CDS is the commonest cause of intramedullary spinal cord abscess. 5 Hear we present an infant with intramedullary abscess presented with paraparesis and bowel and bladder involvement.…”

mentioning

confidence: 96%

A Case of Tubercular Intramedullary Abscess in An Infant

et al. 2016

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Spinal abscess in pediatric age group is a rare entity. Tubercular type is even rarer and it has been found to be associated with patent dermal sinus. Very few cases have been reported so far.We present a 2-month-old baby with gradually progressing paraparesis. There was a small dermal sinus in the lower area of right buttock which was discharging pus. MRI was done which showed intramedullary fluid collection at the level of lower lumbar and sacral spine suggesting abscess formation. Patient party was suggested for surgical exploration and histopathological evaluation. However, they denied and thus baby was put on steroid therapy. The baby gradually improved. However he started having paraparesis again and even worse than before. Repeat MRI showed intramedullary collection more than the previous MRI. Again surgical option was given and finally surgery done. Right hemilaminectomy was done from L3-4-5-S1and dura exposed. Dura was incised and spinal cord, conus and cauda equina exposed which were swollen and congested. Midline myelotomy was done opening the intramedullary. Free flow of thick pus was observed. Dermal sinus was excised and closed.Pus and small pieces of granulation tissue was sent for culture and cytological examination which showed features of tuberculosis. Antitubercular treatment was started and the baby became much better.Nepal Journal of Neuroscience 12:43-45, 2015

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Complications of the Occult Spinal Dysraphisms

Bruzek

Maher

2019

Occult Spinal Dysraphism

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Intramedullary spinal cord abscess: The result of a missed congenital dermal sinus

Cited by 16 publications

References 5 publications

Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

Spinal intramedullar cord abscess which developed as a result of congenital spinal dermal sinus

A Case of Tubercular Intramedullary Abscess in An Infant

Complications of the Occult Spinal Dysraphisms

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