Fatal Meningitis in a 14-Month-Old with Currarino Triad

Qahtani, Hanan Mohammed Al; Aljoqiman, Khalid Suliman; Arabi, Hisham; Shaalan, Hesham Al; Singh, Shailesh

doi:10.1155/2016/1346895

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…On rare occasions, the central nervous system infection may cause vomiting due to increased intracranial pressure, mainly caused by abnormal communication between the fistula and the spinal canal. Central nervous system infection is one of the most serious presentations of CS, and can even lead to death (15). Seven patients (21.9%) presented with vomiting in this study.…”

Section: Discussionmentioning

confidence: 52%

Characterization of complete Currarino syndrome in pediatrics—a comparison between CT and MRI

Chen¹,

Zheng²,

Wang³

et al. 2022

Ann Transl Med

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Background: This study sought to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of the classical triad elements and the associated anomalies in pediatric complete Currarino syndrome (CS) to evaluate the advantages and disadvantages of the 2 different imaging methods in displaying the abnormalities of this disease. Methods:The clinical and radiological features of 32 pediatric patients with complete CS diagnosed histologically and/or radiologically were retrospectively analyzed.Results: All 32 complete CS patients presented with the classical triad of congenital anorectal malformation (ARM), sacral agenesis, and presacral mass. Anal atresia, which is the most common congenital ARM, was observed in 19 of the 32 patients (59.4%). Sacral agenesis was mainly type IV (75%). Among the presacral masses, true tumors and pseudotumors accounted for about half each. All of the 15 true tumors were presacral teratomas. 25 patients had associated anomalies, including tethered cord, filum lipoma, and hydronephrosis. 24 patients underwent both CT and MRI examinations. While CT was better than MRI in displaying sacral anomaly (P<0.05), MRI was more sensitive than CT at detecting presacral mass, spinal dysraphism, and congenital anal atresia (P<0.05).Conclusions: CT and MRI have different efficiencies at displaying the abnormalities of the complete CS.As a non-invasive method, MRI has significant advantages in diagnosing complete CS, especially in revealing the details of ARM, presacral mass, and associated spinal dysraphism.

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Section: Discussionmentioning

confidence: 52%

Characterization of complete Currarino syndrome in pediatrics—a comparison between CT and MRI

Chen¹,

Zheng²,

Wang³

et al. 2022

Ann Transl Med

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“…Tethered cord syndrome is important to identify because it is associated with an increased risk of meningitis, which is one of the lethal complications of Currarino syndrome. 12 Another complication that may occur is pneumocephalus due to erosion of the presacral mass into the rectum, forming a neurenteric fistula.…”

Section: Discussionmentioning

confidence: 99%

Presacral mature cystic teratoma associated with Currarino syndrome in an adolescent with androgen insensitivity: illustrative case

Koskay

Opperman

Mezzacappa

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Currarino syndrome is a rare disorder that classically presents with the triad of presacral mass, anorectal malformation, and spinal dysraphism. The presacral mass is typically benign, although malignant transformation is possible. Surgical treatment of the mass and exploration and repair of associated dysraphism are indicated for diagnosis and symptom relief. There are no previous reports of Currarino syndrome in an androgen-insensitive patient. OBSERVATIONS A 17-year-old female patient presented with lack of menarche. Physical examination and laboratory investigation identified complete androgen insensitivity. Imaging analysis revealed a presacral mass lesion, and the patient was taken to surgery for resection of the mass and spinal cord untethering. Intraoperative ultrasound revealed a fibrous stalk connecting the thecal sac to the presacral mass, which was disconnected without the need for intrathecal exploration. The presacral mass was then resected, and pathological analysis revealed a mature cystic teratoma. Postoperatively, the patient recovered without neurological or gastrointestinal sequelae. LESSONS Diagnosis of incomplete Currarino syndrome may be difficult but can be identified via work-up of other disorders, such as androgen insensitivity. Intraoperative ultrasound is useful for surgical decision making and may obviate the need for intrathecal exploration during repair of dysraphism in the setting of Currarino syndrome.

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“…The known female predominance of Currarino syndrome was confirmed with a F:M ratio of 24:13 (information on the gender of one patient missing). These case reports show that meningitis due to formation of an enterothecal fistula can be fatal [1,16,17]. In the series here described, a posterior surgical approach was chosen in 16 patients and an anterior surgical approach was chosen in 3 patients.…”

Section: Escherichia Coli Bacteroidesmentioning

confidence: 99%

Severe bacterial meningitis due to an enterothecal fistula in a 6-year-old child with Currarino syndrome: evaluation of surgical strategy with review of the literature

et al. 2019

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Meningitis is a rare but serious complication in patients with Currarino syndrome. We present a 6-year-old girl with a fulminant meningitis due to an enterothecal fistula involving the anterior sacral meningocele. Initial treatment consisted of broad-spectrum intravenous antibiotic therapy and laparoscopic construction of a deviating double-loop ileostomy. This was followed by an elective posterior neurosurgical approach with a sacral laminectomy, evacuation of the empyema, and securing the disconnection of the anterior meningocele from the thecal sac, 10 days after initial hospital admission. The girl made a good postoperative recovery. The treatment strategy in the setting of meningitis due to an inflamed anterior meningocele is discussed and the available literature on the topic is reviewed.

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Fatal Meningitis in a 14-Month-Old with Currarino Triad

Cited by 6 publications

References 14 publications

Characterization of complete Currarino syndrome in pediatrics—a comparison between CT and MRI

Characterization of complete Currarino syndrome in pediatrics—a comparison between CT and MRI

Presacral mature cystic teratoma associated with Currarino syndrome in an adolescent with androgen insensitivity: illustrative case

Severe bacterial meningitis due to an enterothecal fistula in a 6-year-old child with Currarino syndrome: evaluation of surgical strategy with review of the literature

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