Sepsis and Spina Bifida

Spina bifida is a neural birth defect, which means it mainly affects the spinal cord. When the spinal cord forms during the first month of pregnancy, sometimes the spinal canal doesn’t close completely. According to the Centers of Disease Control and Prevention (CDC), every year about one out of every 2,758 babies born in the United States has spina bifida. People with spina bifida may have an increased risk of contracting infections, which in turn, increases their risk of developing sepsis.

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Spina Bifida. 2024. https://www.sepsis.org/sepsisand/spina-bifida/

Updated June 18, 2024.

 

More About Spina Bifida

Types

There are three main types of spina bifida:

Spina bifida occulta, the mildest form of the condition, is also the most common. The Spina Bifida Association (SBA) says that up to 15% of healthy people have spina bifida occulta, but they don’t know it. There is a defect in the spinal canal but outside, the skin is fully formed. A child with spina bifida occulta may have a small different-looking patch on the skin right over where the defect is. Sometimes the spina bifida is only detected when someone has x-rays for another reason and the radiologist sees the lesion.

Meningocele is the least common form of spina bifida. When a baby with a meningocele is born, there is an opening in the back. A small part of the meninges, the membranes that surround the spinal cord, come through the opening. In most cases, a surgeon can reinsert the membranes and close up the hole, leaving few neurological (nerve) problems.

Myelomeningocele is the most severe form of spina bifida. A baby with myelomeningocele has a hole in the back. Part of the undeveloped spinal cord comes through that hole. Most children with myelomeningocele also have a condition called Chiari malformation. This causes hydrocephalus, fluid on the brain. People with this form of spina bifida usually do not have control of their lower body, including their bowel and bladder.

Infection Risk

People with myelomeningocele are at higher risk of developing infection. Since there is often no or limited feeling in the lower part of the body, pressure injuries are a constant concern. These injuries could result from sitting in one position in a wheelchair for too long, a brace rubbing against the skin, or injuries that aren’t felt and noticed until they are infected.

People with this form also might also empty their bladder through self-catheterization. This means the person inserts a catheter into their urethra several times a day, instead of urinating in a toilet. The catheter procedure is usually a clean procedure, but not sterile, as it is when done in a hospital. Repeat catheterizations can cause urinary tract infections (UTI). Because there may be no feeling in the lower abdomen, a UTI may be present for a while before someone notices it. If they are incontinent, meaning they pass urine or stool involuntarily, there is always the risk that the urine or stool will cause the skin to develop sores.

Those in this group also may need multiple surgeries. For example, if they have hydrocephalus, they might have a shunt, a tube, inserted to drain fluid from the brain to the abdomen or heart. Shunts can break or become dislodged, requiring surgery.

People with the milder forms – spina bifida occulta or meningocele – are not usually at higher risk of infections, unless they need surgery for a meningocele repair.

Related Resources

Gouri Joshi

Gouri – my daughter age 33 left us last year in July 2021 due to sever sepsis condition. So instead of talking to you guys I prefer to give summary of her hard life. I took her to Europe, USA, Dubai, Singapore, Malaysia , Thailand etc with my wife. My daughter Gouri was case of spina bifida. (Sepsis and Spina Bifida) At the age of 40 days she was operated to close the spinal tail. So soon after birth we went through this situation. She did not have stool or urine control. Due to this when we went for school ... Read Full Story

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