Recurrent Meningitis Associated With Complete Currarino Triad in an Adult-Case Report-

Abstract

A 58-year-old woman presented with Currarino triad manifesting as recurrent meningitis. Currarino triad is a combination of a presacral mass, a congenital sacral bony abnormality, and an anorectal malformation, which is caused by dorsal-ventral patterning defects during embryonic development. She had a history of treatment for anal stenosis in her childhood. Radiographic examinations demonstrated the characteristic findings of Currarino triad and a complicated mass lesion. The diagnosis was recurrent meningitis related to the anterior sacral meningocele. Neck ligation of the meningocele was performed via a posterior transsacral approach after treatment with antibiotics. At surgery, an epidermoid cyst was observed inside the meningocele. The cyst content was aspirated. She suffered no further episodes of meningitis. The meningitis was probably part of the clinical course of Currarino triad. Radiography of the sacrum and magnetic resonance imaging are recommended for patients with meningitis of unknown origin. The early diagnosis and treatment of this condition are important.

Epidermoid cyst inside anterior sacral meningocele in an adult patient of currarino syndrome manifesting with meningitis

“…This complication may be iatrogenic or due to fistulous connection of spinal canal with anus or rectum. Sometimes these cases of meningitis may be idiopathic, rare cases of meningitis with epidermoid cysts containing purulent fluid have been described (2,3). Tiny tear in the wall of these epidermoid cyst have been hypothesized as a cause of meningitis in these cases.…”

Sindrome de currarino associada ao Tailgut Cyst: ressecção abdômino-sacral

“…Kennedy em 1926 e Ashcraft & Holder em 1974 também caracterizaram esta condição 12 . Entretanto, somente em 1981, Currarino a reconheceu como síndrome caracterizada como anomalia de embriogênese 9,10,12 . No período compreendido entre 1926 a 2003 foram descritos mais de 200 casos.…”

“…12 Os sintomas mais comuns em crianças são a constipação intestinal crônica (67%) e a dificuldade urinária (9%), enquanto em adultos, além da constipação, a dificuldade urinária e a dor acometem 20% dos pacientes, respectivamente. A constipação intestinal crônica está presente em 80,4% dos pacientes com menos de 12 anos e 91% após 30 anos 9 . Outras anormalidades que podem estar associadas são hidronefrose, refluxo vesicouretral, duplicação ureteral, rim único, incontinência urinaria, útero bicorno, vagina subseptada e fístula retrovaginal.…”

“…Já foram descritos mais de 200 casos no período de 1926 a 2003. 9 Os cistos de desenvolvimento retrorretais podem estar associados a esta síndrome hereditária. O Tailgut Cyst também conhecido como cisto de cauda intestinal ou hamartoma retrorretal é um remanescente embriológico do intestino posterior, podendo fazer parte desta síndrome.…”

Currarinos syndrom ved Rikshospitalet 1961 – 2012

“…Cases of meningitis associated with Currarino syndrome differ somewhat from meningitis in general in that they are often caused by intestinal bacteria and may be polymicrobial (27). Meningoceles complicated by meningitis, along with malignancy, constitute the two main causes of mortality associated with this syndrome (21,28,29).…”