A case with cauda equina syndrome due to bacterial meningitis of anterior sacral meningocele.
METHODS
A case of a patient with anterior sacral meningocele that was misdiagnosed as perianal abscess is presented. After the transrectal aspiration, the patient developed meningitis and cauda equina syndrome.


OBJECTIVE
To report a rare case of anterior sacral meningocele in which primary presentation was mimicking perianal abscess.


BACKGROUND
Anterior sacral meningocele is a rare example of spinal dysraphism. It is created by a herniation of a dural sac through a defect in the sacral wall. It is usually asymptomatic until later decades. Most of the presenting symptoms are related to the pelvic organs. In the management of anterior sacral meningocele, surgical treatment is necessary.


METHODS
The reported case is that of a 35-year-old female with cauda equina syndrome due to bacterial meningitis of the anterior sacral meningocele. At the beginning, she presented signs and symptoms resembling perianal abscess. She was misdiagnosed as anorectal abscess according to the computed tomography findings. The patient then underwent transrectal aspiration. Following the aspiration, meningitis and cauda equina syndrome were developed. Meningitis was treated with the appropriate antibiotics, and the patient underwent rehabilitation for paraplegia and bladder and bowel incontinence.


RESULTS
Following the rehabilitation program, the patient has recovered completely within 8 months.


CONCLUSIONS
This case represents a rare example of anterior sacral meningocele in which the patient was misdiagnosed as perianal abscess. Meningitis either iatrogenic or spontaneous may occur during the course of anterior sacral meningocele. Once it has occurred, it may result in severe morbidity and mortality. However, our case had been treated effectively, and she had regained her health with rehabilitation program.
Bal
Serpil
S
Department of Physical Medicine and Rehabilitation, Izmir Atatürk Research and Education Hospital, Izmir, Turkey.
Kurtulmuş
SüKran
S
Koçyiğit
Hikmet
H
Gürgan
Alev
A
D000038:Abscess / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000328:Adult; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications* / Q000188:drug therapy; D008588:Meningocele / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D016106:Methicillin Resistance; D011128:Polyradiculopathy / Q000209:etiology* / Q000534:rehabilitation; D011183:Postoperative Complications / Q000209:etiology*; D020127:Recovery of Function; D018805:Sepsis / Q000209:etiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy; D013396:Suction; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents