Posterior fossa dermoid cyst with sinus tract and meningitis in a toddler.
Intracranial dermoid cysts are rare, but can cause recurrent bacterial or aseptic meningitis, abscesses or mass effect. We describe a toddler who manifested an occipital "lump" for 6 months without further evaluation. He presented with lethargy and meningitis. A posterior fossa dermoid cyst with a sinus tract was detected by imaging studies. He underwent prompt surgical excision of the cyst and the sinus, and received a prolonged course of antibiotics, because anaerobes were isolated from the contents of the cyst and blood. His postoperative course was complicated, and required the placement of a lumboperitoneal shunt. A high index of suspicion for the detection of dermoid cysts is required when a congenital midline skin lesion such as a dimple or a scalp swelling is reported. Prophylactic excision is indicated to prevent serious sequelae.
Douvoyiannis
Miltiadis
M
Division of Infectious Diseases, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York 10467, USA. mdouvoyi@montefiore.org
Goldman
David L
DL
Abbott
Ira R
IR
Litman
Nathan
N
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic; D003392:Cranial Sinuses / Q000473:pathology*; D003884:Dermoid Cyst / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D015192:Infratentorial Neoplasms / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000150:complications* / Q000382:microbiology; D008795:Metronidazole / Q000627:therapeutic use; D019635:Neurosurgical Procedures; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin