An Unusual Cause of Headache: Pott??s Puffy Tumour

Abstract

Osteomyelitis of the frontal bone (eponymously known as Pott's puffy tumour) is an extremely rare and potentially life-threatening complication of frontal sinusitis. The entity was first described by Sir Percival Pott, an 18th century neurosurgeon. It is today considered a historical vignette with the introduction of modern antimicrobial agents. Early diagnosis and immediate active treatment are necessary to prevent severe neurologic sequelae. We report on a case of Pott's puffy tumour in a previously healthy young man with a progressively worsening headache and swelling of the frontal bone. Computed tomography and magnetic resonance imaging revealed features characteristic of this condition. Following emergency sinus trephination and 6 weeks of parenteral and enteral antibiotic therapy, the patient achieved a complete recovery.

Puffy Frontal Edema: A Serious Life-Threatening Finding of Pott’s Puffy Tumor: Case Report

“…Antimicrobial therapy should be tailored to the organisms isolated from surgical specimens. 19 Surgery is indicated for abscess drainage, bony debridement, and trephination of the frontal sinus. 21 We aimed to emphasize in this case report that Pott's puffy tumour should be considered when a patient presents with a swelling on the forehead since mortality rate might be as high as 17%.…”

“…19 Imaging with computed axial tomography scan or magnetic resonance defines the extent of the infection. 20 In our case cranial computed tomography scan showed inflammatory changes in the frontal sinuses and soft tissue swelling on the right side of the frontal bone.…”

Pott's puffy tumour: harbinger of intracranial sepsis

“…First documented as a sign of intracranial empyema following head injury (1768) and subsequently as a complication of frontal sinusitis (1775),1 fewer than 20 adult cases have been reported in the post-antibiotic era 2. It has also occurred as a late complication of neurosurgery,3 cocaine abuse4 and dental sepsis 5…”

“…An appropriate combination is ceftriaxone, metronidazole and vancomycin, but consultation with local microbiologists is advised 19. The minimum duration of therapy may be 6 weeks and it may be continued depending upon clinical response 2. Close clinical and radiological follow-up is required to allow the early identification and treatment of recrudescent disease.…”

Complicaciones infecciosas severas del territorio maxilofacial: presentación de casos clínicos

“…Los nuevos exámenes de laboratorio mostraron leucocitos normales y una PCR (proteína C reactiva) aumentada (17mg/L). Luego de la evaluación por Otorrinolaringología y Cirugía Maxilofacial, se solicitó una tomografía computarizada (TC) con contraste de cavidades paranasales y se diagnosticó como tumor inflamatorio de Pott (tumoración y edema de la región frontal causada por un absceso subperióstico secundario a una osteomilitis del seno frontal (4) de foco dentario) (Fig.1).…”