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Posterior Fossa Dermoid Cysts Causing Cerebellar Abscesses in 2 Children

Schlingmann, Tobias Rolf MD, PhD*; Prabhu, Sanjay P. MBBS, MRCPCH, FRCR; Ahmed, Asim A. MD

Infectious Diseases in Clinical Practice: September 2012 - Volume 20 - Issue 5 - p 335–337
doi: 10.1097/IPC.0b013e318234c4f0
Case Reports

Dermoid cysts are benign congenital subcutaneous lesions. Although complications are exceedingly rare, posterior fossa masses and infections are possible presentations. The clinical and radiological diagnosis is often challenging. We therefore report 2 recent cases treated at our institution. A 4-year-old girl presented with irritability, headache, and vomiting. Magnetic resonance imaging of the head showed an infected occipital dermoid cyst with an associated transosseous dermal sinus tract and an adjacent intraparenchymal abscess. She underwent successful surgical resection and treatment with intravenous antibiotics. A 2-year-old girl presented with a 10-day history of daily fevers, vomiting, and abdominal pain. After admission, she had a complex partial seizure. Magnetic resonance imaging of the head showed an occipital dermoid cyst with a transosseous dermal sinus tract as well as a left occipital abscess. She underwent complete surgical resection and was discharged on a 6-week course of intravenous cefepime, vancomycin, and metronidazole.

From the *Department of Medicine, †Divisions of Pediatric Neuroradiology and ‡Infectious Diseases, Children’s Hospital Boston, Boston, MA.

Correspondence to: Asim A. Ahmed, MD, Division of Infectious Diseases, Children’s Hospital Boston, 300 Longwood Ave, Boston, MA 02115. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2012 Lippincott Williams & Wilkins, Inc.