생후 3개월 영아에서 재발하는 뇌수막염으로 발견된 피부동관 1례
A Case of Dermal Sinus Tract with Recurrent Meningitis in a 3-Month-Old Infant
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Spinal dermal sinus tract (DST) is a rare congenital dysraphism that occurs in approximately one in every 2,500 live births. Many studies have reported that cutaneous stigmata overlying the posterior midline neuroaxis may be associated with dermal sinuses, including abnormal pigmentation, hemangioma, hypertrichosis, and benign sacrococcygeal dimples. Spinal DSTs that are connected with sinuses may have diverse clinical presentations and may involve clinical complications, occasionally caused by a neurologic defect, or infectious complications, including life-threatening conditions such as meningitis. A 3-month-old girl had experienced recurrent meningitis without typical abnormal findings on physical and laboratory examinations. Magnetic resonance imaging (MRI) was performed to evaluate infectious conditions, and DST was found incidentally. Although MRI findings revealed DST, we could not find any small opening on the skin on careful observation. Thus, first-line physicians should keep several important factors in mind when initially evaluating patients with recurrent meningitis, such as cutaneous findings over the midline neuroaxis and early neuroimaging studies for congenital dysraphism.
Abstract
Spinal dermal sinus tract (DST) is a rare congenital dysraphism that occurs in approximately one in every 2,500 live births. Many studies have reported that cutaneous stigmata overlying the posterior midline neuroaxis may be associated with dermal sinuses, including abnormal pigmentation, hemangioma, hypertrichosis, and benign sacrococcygeal dimples. Spinal DSTs that are connected with sinuses may have diverse clinical presentations and may involve clinical complications, occasionally caused by a neurologic defect, or infectious complications, including life-threatening conditions such as meningitis. A 3-month-old girl had experienced recurrent meningitis without typical abnormal findings on physical and laboratory examinations. Magnetic resonance imaging (MRI) was performed to evaluate infectious conditions, and DST was found incidentally. Although MRI findings revealed DST, we could not find any small opening on the skin on careful observation. Thus, first-line physicians should keep several important factors in mind when initially evaluating patients with recurrent meningitis, such as cutaneous findings over the midline neuroaxis and early neuroimaging studies for congenital dysraphism.
참고문헌 (19)
- Kaufman BA, "Neural tube defects", Pediatr Clin North Am, 51, pp.389~419 (2004)
- Ramnarayan R, "Congenital spinal dermal sinuses: poor awareness leads to delayed treatment", Childs Nerv Syst, 22, pp.1220~1224 (2006)
- Ackerman LL, "Cervical and thoracic dermal sinus tracts. A case series and review of the literature", Pediatr Neurosurg, 37, pp.137~147 (2002)
- Radmanesh F, "Dermal sinus tract of the spine", Childs Nerv Syst, 26, pp.349~357 (2010)
- Jindal A, "Spinal congenital dermal sinus: an experience of 23 cases over 7 years", Neurol India, 49, pp.243~246 (2001)
- Ackerman LL, "Spinal congenital dermal sinuses:a 30-year experience", Pediatrics, 112, pp.641~647 (2003)
- French BN, "The embryology of spinal dysraphism", Clin Neurosurg, 30, pp.295~340 (1983)
- Kanev PM, "Dermoids and dermal sinus tracts of the spine", Neurosurg Clin N Am, 6, pp.359~366 (1995)
- Martinez-Lage JF, "Hydrocephalus in intraspinal dermoids and dermal sinuses: the spectrum of an uncommon association in children", Childs Nerv Syst, 22, pp.698~703 (2006)
- Elton S, "Dermal sinus tracts of the spine", Neurosurg Focus, 10, pp.e4~ (2001)
- Lew SM, "Tethered cord syndrome: an updated review", Pediatr Neurosurg, 43, pp.236~248 (2007)
- Tubbs RS, "An unusual sequelae of an infected persistent dermal sinus tract", Childs Nerv Syst, 23, pp.569~571 (2007)
- Cheek WR, "Dermal sinus tracts", Concepts Pediatr Neurosurg, 6, pp.63~75 (1985)
- Park T, "Occult spinal dysraphism", Neurological surgery, 2, pp.873~889 (1996)
- 홍미, "신생아의 천골부 피부병변과 잠재된 척추병변과의 연관성", Neonatal medicine, 21(1), pp.46~51 (2014), 대한신생아학회
- Schenk JP, "Imaging of congenital anomalies and variations of the caudal spine and back in neonates and small infants", Eur J Radiol, 58, pp.3~14 (2006)
- Unsinn KM, "US of the spinal cord in newborns: spectrum of normal findings, variants, congenital anomalies, and acquired diseases", Radiographics, 20, pp.923~938 (2000)
- Kara NN, "Spinal congenital dermal sinus associated with upper thoracic meningocele. Case report", Neurosurg Focus, 15, pp.Ecp2~ (2003)
- McLone DG, "Pediatric neurosurgery: surgery of the developing nervous system" (2001), Saunders