Tender Cystic Structure on the Back in an Infant

Area of Science:

• Pediatric Neurology
• Congenital Malformations
• Infectious Diseases

Background:

• Recurrent febrile episodes in infants can indicate underlying serious pathology.
• Congenital anomalies, such as spinal malformations, may predispose to infections.
• Persistent meningitis requires thorough investigation for underlying causes.

Observation:

• A 1-year-old boy with multiple congenital anomalies presented with recurrent fever.
• A tender, erythematous, purulent cystic structure was noted on his upper back.
• Magnetic resonance imaging revealed a sinus tract connecting the superficial lesion to deeper spinal structures.

Findings:

• The patient was diagnosed with Staphylococcus epidermidis meningitis, resistant to medical treatment.
• A congenital spinal sinus tract was identified as the source of recurrent infection.
• The sinus tract extended from a superficial back lesion to cystic structures at the level of hemivertebrae.

Implications:

• Congenital spinal sinus tracts are a potential source of recurrent meningitis in infants.
• Early identification and surgical management of spinal sinus tracts are crucial for resolving persistent infections.
• This case highlights the importance of considering spinal anomalies in pediatric patients with recurrent meningitis.