영아기에 연속적인 세균성 뇌수막염으로 발현한 선천성 피부동 증례 1례

A Case of Recurrent Bacterial Meningitis Associated with Lumbosacral Dermal Sinus during E arly Infancy

본 저자들은 신생아시기부터 반복적인 화농성뇌수막염을 앓은 소아에서 천추부 함몰과 피부착색으로 의심되어 시행한 자기공명영상 상 신경조직과 교통이 있는 선천성 피부동 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Acute bacterial meningitis is an uncommon, potentially life-threatening infection and recurrent episodes of bacterial meningitis are rarely seen. But when they occur, an exhaustive search for the mechanisms underlying the recurrent episodes must be pursued, especially some possible routes of migration of bacteria to the cerebrospinal fluid. Dermal sinus tracts are common skin manifestations seen with spinal dysraphism and may be associated with recurrent meningitis. Here, we present a case of a 2-month-old girl who had a small dimple on the lower lumbosacral area. She was attacked twice by purulent bacterial meningitis due to a dermal sinus tract and a tethered cord. She was treated with the excision of the tract, the removal of the dermoid and the detethering of the cord. Staphylococcus and Klebsiella were cultured separately and assumed to be causative agents. The lesion was suspected on the physical examination and demonstrated by lumbosacral magnetic resonance imaging.