Related Experiment Videos
[Perianal fistula as a cause of meningitis?]
B Hanimann1, J Hirsig, M Meuli
1Chirurgische Klinik, Universitätskinderspital Zürich.
Abstract:
In childhood perianal fistulas are frequent. The origin of the fistula is the anorectal line, especially from the Morgagni crypts. Local recurrence of abscesses are observed. Due to two observations we conclude that the fistulas caused a sepsis with E. coli. In one case meningitis and a consecutive empyema occurred, in a second case pyelonephritis. In the following we describe the patient with meningitis and subdural empyema.
Insights
Childhood perianal fistulas can lead to serious E. coli sepsis. These infections may cause severe complications like meningitis and empyema in children.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Perianal fistulas are common in children, often originating from the anorectal line, particularly Morgagni crypts.
- Recurrent abscesses are a known complication of pediatric perianal fistulas.
Observation:
- Two cases are presented where perianal fistulas led to sepsis caused by Escherichia coli.
- One patient developed meningitis and subsequent subdural empyema.
- The second patient experienced pyelonephritis secondary to the E. coli sepsis.
Findings:
- Perianal fistulas in children can be a source of severe systemic infections.
- Escherichia coli sepsis originating from anorectal fistulas can lead to significant morbidity.
- Meningitis and subdural empyema are potential, life-threatening complications.
Implications:
- Early recognition and management of perianal fistulas are crucial to prevent sepsis in children.
- Aggressive treatment of E. coli sepsis is necessary to avoid severe sequelae.
- Further research into the pathogenesis and optimal management of fistulas leading to sepsis is warranted.