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

Eur Spine J. 2014 May:23 Suppl 2:192-6. doi: 10.1007/s00586-013-2930-2. Epub 2013 Aug 3.

Abstract

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.

Conclusion: Literature review confirms that an early diagnosis followed by prompt surgical spinal cord decompression gives a functional neurological recovery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abscess / complications
  • Abscess / microbiology
  • Abscess / surgery*
  • Cervical Vertebrae / surgery*
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / surgery*
  • Humans
  • Infant
  • Laminectomy
  • Male
  • Paresis / etiology
  • Proteus Infections / diagnosis
  • Proteus mirabilis / isolation & purification
  • Spina Bifida Occulta / complications
  • Spina Bifida Occulta / surgery*
  • Spinal Cord Diseases / complications
  • Spinal Cord Diseases / microbiology
  • Spinal Cord Diseases / surgery*