Infected Intraparenchymal Dermoids: An Underestimated Entity

Infection secondary to a dermal sinus most commonly occurs in the form of cutaneous, epidural, or subdural abscesses. Rarely, it can result in an intramedullary abscess as a result of a dermal sinus. This study presents a clinicoradiological profile of 19 cases harboring abscesses within the dermoid...

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Bibliographic Details
Published in:Journal of child neurology 2008-09, Vol.23 (9), p.1011-1016
Main Authors: Mohindra, Sandeep, Gupta, Rahul, Chhabra, Rajesh, Gupta, Sunil K., Pathak, Ashis, Bal, Amanjit K., Radotra, Bishan D.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Brain Abscess - microbiology
Brain Abscess - pathology
Brain Abscess - therapy
Brain Stem - microbiology
Brain Stem - pathology
Brain Stem - surgery
Central Nervous System Bacterial Infections - etiology
Central Nervous System Bacterial Infections - pathology
Central Nervous System Bacterial Infections - therapy
Central Nervous System Neoplasms - complications
Child
Child, Preschool
Craniotomy
Dermoid Cyst - complications
Humans
Infant
Infratentorial Neoplasms - complications
Laminectomy
Magnetic Resonance Imaging
Male
Myelitis - microbiology
Myelitis - pathology
Myelitis - therapy
Neurosurgical Procedures
Postoperative Complications - physiopathology
Recurrence
Spinal Cord - microbiology
Spinal Cord - pathology
Spinal Cord - surgery
Spinal Cord Compression - microbiology
Spinal Cord Compression - pathology
Spinal Cord Compression - therapy
Staphylococcus aureus
Treatment Outcome
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Summary:Infection secondary to a dermal sinus most commonly occurs in the form of cutaneous, epidural, or subdural abscesses. Rarely, it can result in an intramedullary abscess as a result of a dermal sinus. This study presents a clinicoradiological profile of 19 cases harboring abscesses within the dermoids and highlights the importance of dermal sinus acting as a pathway for infections to enter the nervous system. Emergent exploration, pus drainage, and minimal abscess wall excision along with prolonged antibiotic administration remained the management of choice in all cases. Methicillin-sensitive Staphylococcus aureus was the commonest offending organism. In all, 7 patients recovered to normal neurological status, 5 showed no improvement, and 7 improved partially. Improvement in motor power was noted, albeit partially, but bladder functions failed to recover even at long-term follow-up. Even when such infective complications of dermal sinuses are rare, these are potentially serious and disabling.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073808316373