Question
A 7-day old infant has a leaky meningomyelocele. The most useful test for diagnosis and management of the condition is –
| A. |
Blood-culture and sensitivity
|
| B. |
Urine-culture and sensitivity
|
| C. |
Rectal swab-culture and sensitivity
|
| D. |
Wound swab-culture and sensitivity
|
Show Answer
|
Correct Answer » D
Explanation
|
|
Meningomyelocele is a neural tube defect where meninges & spinal cord
herniate through a vertebral defect. A leaking sac means:
– CNS directly exposed to outside
– ↑ risk of local infection & meningitis
Explanation of the Correct Answer
Wound swab culture is most useful because:
– Samples the leaking sac directly
– Identifies organisms colonizing the lesion
– Guides antibiotic choice by sensitivity
It is the most relevant & immediate investigation for management.
Neural tube defect with herniation of meninges & spinal cord
Clinical Features
– Lumbosacral swelling, leaking sac
– Neurological deficits
– Risk of infection
Complications
– Meningitis, sepsis
– Hydrocephalus
Management
– Early surgical closure
– Infection prevention
– Antibiotics guided by wound culture
Explanation of Other Options
A. Blood culture detects systemic infection but not local lesion cause
B. Urine culture irrelevant for meningomyelocele
C. Rectal swab doesn’t assess infected sac
