title: Are mothers always right? When acute meningitis is something more.
abstract: A 22-month-old girl with a history of a congenital occipital cutaneous cyst was brought to the paediatric emergency department for lethargy and occipital headache. She had been discharged 5 days before for acute meningitis without bacterial isolates. At physical observation, she presented with irritability and neck hyperextension, with negative meningeal signs. CT scan revealed a vermian cyst and hydrocephalus. She was submitted to neurosurgery with removal of an infected midline dermoid cyst with a fistulous track to the skin. Surgery was successful and without complications. During follow-up, the child was asymptomatic with normal psychomotor development.
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: Catarina
authors.identifier: http://orcid.org/0000-0003-2132-7451
authors.initials: C
authors.lastname: Gomes
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Romão
authors.affiliation: Department of Neurosurgery, Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisbon, Portugal.
authors.forename: Jose
authors.initials: J
authors.lastname: Miguens
authors.affiliation: Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Mouzinho
mesh_terms: D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003560:Cysts / Q000151:congenital; D003884:Dermoid Cyst / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005402:Fistula; D006257:Head; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007223:Infant; D007239:Infections / Q000150:complications; D053609:Lethargy / Q000175:diagnosis / Q000209:etiology; D008581:Meningitis / Q000175:diagnosis* / Q000209:etiology; D009035:Mothers; D054259:Neural Tube; D019635:Neurosurgical Procedures; D012878:Skin Neoplasms / Q000151:congenital; D014057:Tomography, X-Ray Computed