The spinal dermal sinus tracts in the lumbosacral region are not usually recognized, especially when they are not associated with other cutaneous lesions. In these sites, the sinus tracts communicate with the dura in 90% of cases, leading to an important risk of meningitis. CASE REPORTS: Two infants (9 and 12 months old) were hospitalized for meningitis. The hospitalization was preceded two weeks earlier by stubborn constipation, which revealed a neural compression. The physical and MRI examination showed a lumbosacral sinus in contact with a dermoid or an epidermoid tumor. These cysts were infected with anaerobic organisms. Despite surgery and antibiotic therapy, one child remained paraplegic. CONCLUSION: Dermal sinuses above the intergluteal crease should be surgically excised at the time of diagnosis in all patients, regardless of the patient's age or neurologic findings.
PMID: 11396110 [PubMed - indexed for MEDLINE]