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.
Department of Pediatrics, Kumamoto Chuo Hospital
|Received||May 14, 2009|
|Accepted||July 6, 2009|