title: Meningitis complicating an occult infected nasal epidermoid cyst in a child.
abstract: Congenital nasal epidermoid cyst without associated facial dysmorphism is an uncommon anomaly that is often asymptomatic. We report a case of occult nasal epidermoid cyst in a 12-year-old boy with initial nonspecific symptoms of fever, headache, abdominal pain, vomiting, and diarrhea. An enhanced magnetic resonance imaging (MRI) showed a cystic lesion in the frontal skull base with expansion of the foramen cecum and the perpendicular plate of the ethmoid bone, accompanied with meningitis. An emergent surgical intervention was undertaken, and an infected epidermoid cyst was confirmed by pathology. He recovered uneventfully during a 4-week treatment with parentally-administered antibiotics. This significant case report demonstrates the importance of MRI in the early diagnosis of a life-threatening intracranial infection from an otherwise occult infected congenital nasal epidermoid cyst in children.
authors.affiliation: Department of Pediatrics, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Mu-Ling
authors.initials: ML
authors.lastname: Hsu
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Yiao-Hsiang
authors.initials: YH
authors.lastname: Lien
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Wang
authors.forename: Yeong-Seng
authors.initials: YS
authors.lastname: Yuh
authors.forename: Shyi-Jou
authors.initials: SJ
authors.lastname: Chen
mesh_terms: D002648:Child; D004814:Epidermal Cyst / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D009668:Nose Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy