Sub-galeal abscess: A rare sequel of an infected scalp sebaceous cyst

Subgaleal abscess is a rare condition in which suppuration under the galea aponeurotica (epicranial aponeurosis) occurs. Diagnosis of subgaleal abscess is guided by high index of suspicion, imaging of the head by computed topography will confirm the diagnosis and detect osteomyelitis or intracranial extension.

We describe a case of extensive subgaleal abscess that presented as an infected scalp sebaceous cyst, in male diabetic patient, its management and the role of vaccum assisted closure (V.A.C.) dressing which was never described in such atypical presentation.

The subgaleal space is the between the galea aponeurotica and periosteum of the cranial bones, subgaleal abscess may result from hematogenous infection or contiguous spread, and the diagnosis may not be initially obvious⁴ The predominant organism isolated from post-traumatic and post-surgical scalp infections is Staphylococcus aureus (Haines and Chou, 1985). Diagnosis and management will be guided by head CT scan, management of subgaleal abscess should focus on effective intravenous antibiotic therapy, immediate surgical drainage of abscess and debridement of necrotic tissue.

Subgaleal abscess is a rare complication, imaging can prevent serious complications. Negative pressure wound therapy is an invaluable tool for closure of the wounds.