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[Meningitis as a complication of anterior-sacral meningocele]
1Neurochirurgischen Abteilung, Humboldt-Universität zu Berlin.
Abstract:
A 19-year-old young man was admitted with a serious clinical picture of an infected anterior sacral meningocele. Escherichia coli was identified as the pathogenic organism in the spinal putrid fluid. A catheter percutaneously introduced in the hernial sac served as an external drainage of the fluid. At the same time a systemic antibiotic treatment was carried out. After the sanation, the opening of the meningocele was surgically closed in the interval transdurally from the dorsal direction. For this fibrinous adhesive was used in addition to the suture. After six months the hernial sac closure could be demonstrated in the check-up myelo- and computer tomogram.
Insights
A young man with an infected anterior sacral meningocele, caused by Escherichia coli, was successfully treated with catheter drainage, antibiotics, and surgical closure. Follow-up imaging confirmed successful hernial sac closure six months post-treatment.
Area of Science:
- Neurosurgery
- Infectious Diseases
Background:
- Anterior sacral meningoceles are rare congenital abnormalities, and infection presents a significant clinical challenge.
- Infection of a meningocele can lead to serious neurological complications and systemic illness.
Observation:
- A 19-year-old male presented with a critically ill state due to an infected anterior sacral meningocele.
- Cerebrospinal fluid analysis identified Escherichia coli as the causative pathogen.
Findings:
- A percutaneous catheter provided external drainage of the infected fluid, alongside systemic antibiotic therapy.
- Surgical intervention involved transdural closure of the meningocele from a dorsal approach, utilizing sutures and fibrinous adhesive.
- Post-treatment imaging, including myelography and computed tomography, confirmed successful hernial sac closure at six months.
Implications:
- This case highlights a successful multi-modal treatment strategy for infected anterior sacral meningoceles.
- The findings suggest that prompt diagnosis and combined conservative and surgical management can lead to favorable outcomes.
- This approach may serve as a valuable reference for managing similar rare pediatric and young adult neurosurgical emergencies.