Infected intraparenchymal dermoids: an underestimated entity.
Infection secondary to a dermal sinus most commonly occurs in the form of cutaneous, epidural, or subdural abscesses. Rarely, it can result in an intramedullary abscess as a result of a dermal sinus. This study presents a clinicoradiological profile of 19 cases harboring abscesses within the dermoids and highlights the importance of dermal sinus acting as a pathway for infections to enter the nervous system. Emergent exploration, pus drainage, and minimal abscess wall excision along with prolonged antibiotic administration remained the management of choice in all cases. Methicillin-sensitive Staphylococcus aureus was the commonest offending organism. In all, 7 patients recovered to normal neurological status, 5 showed no improvement, and 7 improved partially. Improvement in motor power was noted, albeit partially, but bladder functions failed to recover even at long-term follow-up. Even when such infective complications of dermal sinuses are rare, these are potentially serious and disabling.
Mohindra
Sandeep
S
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sandeepmohindra@gmail.com
Gupta
Rahul
R
Chhabra
Rajesh
R
Gupta
Sunil K
SK
Pathak
Ashis
A
Bal
Amanjit K
AK
Radotra
Bishan D
BD
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D001933:Brain Stem / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D020806:Central Nervous System Bacterial Infections / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016543:Central Nervous System Neoplasms / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D003884:Dermoid Cyst / Q000150:complications*; D006801:Humans; D007223:Infant; D015192:Infratentorial Neoplasms / Q000150:complications; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000503:physiopathology; D012008:Recurrence; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents