Cargando…

Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature

PURPOSE: Congenital dermal sinuses are a rare form of spinal dysraphism. The developmental defects are located along the midline neuroaxis, with sinuses in the cervical region being the least common. Congenital dermal sinuses can be associated with intraspinal infection as they act as a direct route...

Descripción completa

Detalles Bibliográficos
Autores principales: Bevan, Rhian, Leach, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790787/
https://www.ncbi.nlm.nih.gov/pubmed/32632578
http://dx.doi.org/10.1007/s00381-020-04778-1
_version_ 1783633495145316352
author Bevan, Rhian
Leach, Paul
author_facet Bevan, Rhian
Leach, Paul
author_sort Bevan, Rhian
collection PubMed
description PURPOSE: Congenital dermal sinuses are a rare form of spinal dysraphism. The developmental defects are located along the midline neuroaxis, with sinuses in the cervical region being the least common. Congenital dermal sinuses can be associated with intraspinal infection as they act as a direct route from the skin and subcutaneous tissues into the spinal cord. METHODS: The authors present two cases of cervical dermal sinuses complicated by intramedullary abscess. Both children presented with neurological decline and febrile illness. MRI showed intraspinal abscess. Both underwent prompt surgical excision of the sinus tract, exploration of the cord and intravenous antibiotics. RESULTS: Both patients demonstrated excellent neurological recovery. CONCLUSIONS: Complete surgical excision of the sinus and tract in addition to long-term antimicrobials can yield excellent neurological outcomes. At surgery, do not expect to find pus when exploring the intramedullary component. Long-term follow-up is advocated due to potential late recurrence.
format Online
Article
Text
id pubmed-7790787
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-77907872021-01-11 Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature Bevan, Rhian Leach, Paul Childs Nerv Syst Original Article PURPOSE: Congenital dermal sinuses are a rare form of spinal dysraphism. The developmental defects are located along the midline neuroaxis, with sinuses in the cervical region being the least common. Congenital dermal sinuses can be associated with intraspinal infection as they act as a direct route from the skin and subcutaneous tissues into the spinal cord. METHODS: The authors present two cases of cervical dermal sinuses complicated by intramedullary abscess. Both children presented with neurological decline and febrile illness. MRI showed intraspinal abscess. Both underwent prompt surgical excision of the sinus tract, exploration of the cord and intravenous antibiotics. RESULTS: Both patients demonstrated excellent neurological recovery. CONCLUSIONS: Complete surgical excision of the sinus and tract in addition to long-term antimicrobials can yield excellent neurological outcomes. At surgery, do not expect to find pus when exploring the intramedullary component. Long-term follow-up is advocated due to potential late recurrence. Springer Berlin Heidelberg 2020-07-06 2021 /pmc/articles/PMC7790787/ /pubmed/32632578 http://dx.doi.org/10.1007/s00381-020-04778-1 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Bevan, Rhian
Leach, Paul
Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title_full Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title_fullStr Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title_full_unstemmed Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title_short Infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
title_sort infected congenital cervical dermal sinuses leading to spinal cord abscess: two case reports and a review of the literature
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790787/
https://www.ncbi.nlm.nih.gov/pubmed/32632578
http://dx.doi.org/10.1007/s00381-020-04778-1
work_keys_str_mv AT bevanrhian infectedcongenitalcervicaldermalsinusesleadingtospinalcordabscesstwocasereportsandareviewoftheliterature
AT leachpaul infectedcongenitalcervicaldermalsinusesleadingtospinalcordabscesstwocasereportsandareviewoftheliterature