A 14-month-old toddler with a previously unrecognized dermal sinus tract presented with hydrocephalus and raised intracranial pressure. CT and MRI revealed a large posterior fossa dermoid mass. Cultures obtained from CSF and posterior fossa subdural empyema were positive for both Staphylococcus aureus and Escherichia coli. To the authors's knowledge, this is the first such report.
Conclusion: This case suggests that children who present with CNS infections with unusual pathogens should be carefully evaluated for the presence of anatomic abnormalities including dermal sinus tracts.