Cervical dermal sinus complicated with intramedullary abscess in a child: case report and review of literature. 2014

Zelletta Nicola, and Calace Antonio, and Antonio De Tommasi
Dipartimento di Neurochirurgia, Università degli Studi di Bari, Piazzale Giulio Cesare, Bari, 70124, Italy, nicolazelletta@yahoo.it.

BACKGROUND Dermal sinus tract (DST) is an uncommon spinal dysraphism presenting in childhood along the midline neuroaxis. Cervical DST less frequent is in association with intramedullary abscess. METHODS A 9-month-old baby was admitted to our unit suffering from right hemiparesis. Physical examination showed a cervical midline cutaneous fistula dripping a yellowish thick liquid. Cervical MRI showed at C5 level a sinus tract in continuity with a C3-C6 intramedullary lesion. Total removal of the fistula and the intramedullary lesion was performed. Histopathological examination confirmed the diagnosis of dermal sinus and abscess. RESULTS Post-operative cervical MRI showed a complete removal of the spinal dysraphism, fistula, and intramedullary abscess. The baby showed a progressive clinical improvement and was discharged on day 10 post-surgery. CONCLUSIONS Literature review confirms that an early diagnosis followed by prompt surgical spinal cord decompression gives a functional neurological recovery.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007796 Laminectomy A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots. Laminotomy,Laminectomies,Laminotomies
D008297 Male Males
D010291 Paresis A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for PARALYSIS (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis (see NEUROSYPHILIS). "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as PARAPARESIS. Hemiparesis,Muscle Paresis,Brachial Paresis,Crural Paresis,Lower Extremity Paresis,Monoparesis,Muscular Paresis,Upper Extremity Paresis,Brachial Pareses,Crural Pareses,Extremity Pareses, Lower,Extremity Pareses, Upper,Extremity Paresis, Lower,Extremity Paresis, Upper,Hemipareses,Lower Extremity Pareses,Monopareses,Muscle Pareses,Muscular Pareses,Pareses,Pareses, Brachial,Pareses, Crural,Pareses, Lower Extremity,Pareses, Muscle,Pareses, Muscular,Pareses, Upper Extremity,Paresis, Brachial,Paresis, Crural,Paresis, Lower Extremity,Paresis, Muscle,Paresis, Muscular,Paresis, Upper Extremity,Upper Extremity Pareses
D011512 Proteus Infections Infections with bacteria of the genus PROTEUS. Infections, Proteus,Infection, Proteus,Proteus Infection
D011513 Proteus mirabilis A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is frequently isolated from clinical specimens. Its most common site of infection is the urinary tract.
D002574 Cervical Vertebrae The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK. Cervical Spine,Cervical Spines,Spine, Cervical,Vertebrae, Cervical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000038 Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Abscesses
D013118 Spinal Cord Diseases Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. Myelopathy,Spinal Cord Disorders,Myelopathies,Spinal Cord Disease,Spinal Cord Disorder

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