Spinal cord abscess secondary to infected dorsal dermal sinus in an infant: uncommon presentation of a known entity

Abstract

Infection along the congenital dermal sinus tract is well known. However, congenital dorsal dermal sinus presenting with intramedullary abscess is quite rare. The sinus tract usually presents in the midline and acts as a portal of entry for infection that may manifest as meningitis, extradural or subdural abscess and may further involve the cord. Surgical drainage of pus and complete excision of the sinus tract is the standard treatment. Here we describe an infant with an infected congenital dorsal dermal sinus with atypical presentation as large paracentral abscess in the upper back. We further highlight the importance of recognising and treating these skin dimples even when clinically silent to avoid catastrophic complications.

What Is Currently Known about Intramedullary Spinal Cord Abscess among Children? A Concise Review

“…In total, 122 papers potentially pertaining to the topic of the study were enrolled in the full-text assessment for eligibility. In these 122 papers, we identified 58 papers regarding pediatric ISCA with the description on 64 cases [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ].…”

Dermal sinus tracts

“…About 18% of patients present with infection, at a median age of 2.5 years 26. This can range from a local infection at the orifice, to meningitis, spinal abscess, and brain abscess 127891011…”