Article in Japanese

A case of occipital dermal sinus with intracranial dermoid cyst complicated by MSSA meningitis

Takahiro Nishihara¹⁾, Akio Furuse¹⁾, Seishi Seguchi¹⁾, Motoko Tsuruta¹⁾

We report a 2-year-old girl of occipital dermal sinus with refractory meningitis. She was referred to our hospital with high fever and "not doing well". Clinical examination at admission revealed meningeal sign and a palpable subcutaneous mass at the occipital area. We diagnosed bacterial meningitis caused by Staphyrococcus aureus. We treated with antibiotics, however, high fever was continued. MRI showed a mass lesion in the cisterna magna which connected to the subcutaneous mass through a occipital bone defect. T1-weighted images with Gd-DTPA showed dermoid cyst with brain abscess. She was transferred to Kumamoto University hospital, and both of dermal sinus and brain mass were removed completely. The postoperative course was satisfactory.
The occipital dermal sinus, which is complicated with seriousness such as meningitis, should be diagnosed at uncomplicated stage especially neonatal stage. Because the hair is thin, the occipital dermal sinus is more easily noticed, therefore we must carefully observe the occipital area at the neonatal screening.

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Department of Pediatrics, Kumamoto Chuo Hospital

Key words
Received	May 14, 2009
Accepted	July 6, 2009

21 (3)：230─234,2009