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

Mamoun Nabri; Mohammed Alharbi; Amnah Al-Sayyid; Kawthar Alabdrabalrasol; Khairi Hassan; Hussam Al-Jehani

doi:10.1016/j.ijscr.2020.09.063

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

Int J Surg Case Rep. 2020:76:30-32. doi: 10.1016/j.ijscr.2020.09.063. Epub 2020 Sep 24.

Authors

Mamoun Nabri¹, Mohammed Alharbi², Amnah Al-Sayyid³, Kawthar Alabdrabalrasol⁴, Khairi Hassan², Hussam Al-Jehani⁵

Affiliations

¹ Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Electronic address: manabri@iau.edu.sa.
² Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
³ Medical Intern, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
⁴ Medical Student in Imam Abdulrahman Bin Faisal University, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
⁵ Department of Neurosurgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Abstract

Introduction: 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.

Presentation of case: 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.

Discussion: 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.

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

Keywords: Abscess; Cyst; Dressing; Sebaceous; Subgaleal; Vacuum.

Publication types

Case Reports