Neurogenic bladder in an infant due to spinal arachnoid cyst

The urinary bladder of patients with occult spinal defects may become dysfunctional, exposing the renal parenchyma to irreversible damage. However, during infancy clinical signs are often misdiagnosed. The treatment should be aimed at protecting kidneys from severe bladder dysfunction. We report a case of a female infant with an arachnoid cyst diagnosed at the age of 6 months, who suffered from intractable, repeated febrile urinary tract infections (UTI) for the previous 3 months. The images obtained by ultrasonography and voiding cystoureterography techniques were typical of a neurogenic bladder. The spinal cord was examined by magnetic resonance imaging (MRI), which revealed an arachnoid cyst that was surgically treated when the child was 8 months old. The postoperative results were excellent: spinal cord MRI was normal after 1 year, and the child experienced only one UTI episode in the next 2 years. Such an etiology of neurogenic bladder has never been reported in a 6-month-old child.