Pott’s puffy tumor: ct and mri findings

Acke, Frederic; Lemmerling, Marc; Heylbroeck, Ph; Vos, Geert De; Verstraete, Koenraad

doi:10.5334/jbr-btr.703

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…Pott's puffy tumor consists of a subperiosteal abscess with osteomyelitis of the frontal bone. 9 PTT is commonly related as a complication of a frontal or ethmoidal sinusitis, acute or chronic, but can see cases related after front bone trauma 11,12,29 , and even barotrauma can be associated. 13 PPT is a disease with low incidence and with few cases reported; this can be explained nowadays due to the widespread use of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…A scintigraphy evaluation can be useful in detecting and diagnosis of osteomyelitis. 12 In addition, the ultrasound forehead images can assist in the initial radiological investigation and guide the needle sampling for culture. 21 The physiopathology of PPT made the necessity of immediate antibiotic therapy and the improvement based on the study of the pathogens clear.…”

Section: Third Generation Of Cephalosporinmentioning

confidence: 99%

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Pott’s Puffy Tumor - Overview of case series

Severo

Medeiros²,

Gadelha³

et al. 2021

jmm

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Pott’s puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis that has been neglected or partially treated, resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis, which can lead to life-threatening intracranial complications, such as epidural/subdural empyema, cerebral abscess and meningitis. Given this, the purpose of the present study was to gather the most diverse cases reported together to highlight the main treatment methods. Methods: It is a narrative review, starting from the search in the database PubMed, Lilacs and Scielo from 2010 to 2020, which resulted in 34 scientific articles. The search focused on obtaining data on new approaches and treatments established for Pott’s puffy tumor. Results: 34 articles were included which described 58 patients with a swollen Pott tumor, occurring predominantly in male adolescents, with streptococci (26,1%) as the main etiologic agent. Approximately 84% of all patients were male subjects. The most prevalent intracranial complication was an epidural or extradural abscess (84,2%). Regarding PTT therapy, all patients received antibiotic therapy (ATB), and the main empirical antimicrobial scheme used was cephalosporin third generation, with vancomycin and metronidazole. In most cases, surgery was performed using several techniques, mainly an external surgical approach, external drainage (ED) of the subperiosteal abscess associated with endoscopic sinus surgery (ESS). In general, the prognosis is favorable, even if neurological symptoms are present at admission. Conclusion: Based on available literature, PPT is a profoundly serious complication, which can be easily avoided if treated with the ATB, ED and ESS triad immediately, and, if necessary, craniotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Third Generation Of Cephalosporinmentioning

confidence: 99%

Pott’s Puffy Tumor - Overview of case series

Severo

Medeiros²,

Gadelha³

et al. 2021

jmm

View full text Add to dashboard Cite

show abstract

“…Magnetic resonance imaging could demonstrate inflammation (or abscess) without contrast [1,23], so that it might be useful in evaluating a deceased's condition.…”

Section: Discussionmentioning

confidence: 99%

Lethal complication in Pott's Puffy tumor: A case report

Hyodoh

Matoba

Murakami

et al. 2018

Journal of Forensic Radiology and Imaging

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A man in his fifties was found dead in his bed. Using postmortem CT, the frontal sinus wall was seen to have been destroyed and a subcutaneous / intra-cranial mass-like lesion was detected. Postmortem blood biochemical examination demonstrated high values of urea nitrogen, c-reactive protein, procalcitonin, and precepsin, which were thought to be due to sepsis. Needle aspiration showed reddish viscous fluid, and the presence of Klebsiella oxytoca was confirmed by culture inspection. Based on these results, Pott's puffy tumor with intracranial empyema, and dehydration with sepsis in the agonal period was assessed as the cause of death. Using autopsy evaluation, it was possible to come to a concrete conclusion, but a minimally invasive autopsy might be an alternative approach to investigate the cause of death.

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“…This rare but grave clinical entity can be misdiagnosed with benign or malignant neoplasms, soft-tissue and skin infections, and infected haematoma of the frontal area. Contrast-enhanced CT is the most adequate imaging method for the diagnosis of PPT ( 10 ). CT is the best method for the visualization of bony structures.…”

Section: Discussionmentioning

confidence: 99%

“…It provides excellent visualization of air-bone and air-soft tissue interfaces. MRI provides a superior soft tissue resolution and more detail in the description of the extent of the disease, and enables better evaluation of the underlying subdural space and brain ( 5 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

A Pott’s Puffy Tumor Associated with Epidural - Cutaneous Fistula and Epidural Abscess: Case Report

2017

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Background:Pott’s puffy tumour is characterized by a fluctuate swelling of the frontal region as a result of osteomyelitis of the frontal bone. This inflammatory lesion may propagate endocranially, resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis, and frontal lobe abscess of the brain.Case Report:We present an unusual case of a 33-year-old man suffering from Pott’s puffy tumour whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess. We confirmed the diagnosis by contrast-enhanced computed tomography scanning and magnetic resonance imaging of the head. After intense antibiotic treatment, we performed a combined endoscopic and external surgical approach with drainage of abscesses, evacuation of pus and bone sequestrate and excision of fistulous lesion. The treatment was prolonged with four weeks’ antibiotic administration.Conclusion:Subperiosteal abscess of the frontal bone is an extremely rare complication of frontal sinusitis. This lesion may propagate endocranially, resulting in dangerous intracranial inflammatory lesions. Early diagnosis, medication and surgical therapy are very important in reducing morbidity and mortality.

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Pott’s puffy tumor: ct and mri findings

Cited by 8 publications

References 8 publications

Pott’s Puffy Tumor - Overview of case series

Pott’s Puffy Tumor - Overview of case series

Lethal complication in Pott's Puffy tumor: A case report

A Pott’s Puffy Tumor Associated with Epidural - Cutaneous Fistula and Epidural Abscess: Case Report

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