Pseudotumor inflamatorio de Pott: una complicación olvidada y peligrosa de la sinusitis

Abstract

El pseudotumor inflamatorio de Pott es una de las posibles complicaciones de la sinusitis. En la literatura existen pocos casos reportados de esta entidad, pero el presente artículo expone cuatro casos con el propósito de concientizar al grupo médico sobre la existencia de esta enfermedad y cómo su manejo temprano puede prevenir complicaciones severas.

Pott’s puffy tumor: A rare complication of sinusitis. A case report

“…Firstly, pneumatization of the frontal sinuses, which begins around 6 years of age and is completed between 12 and 15 years of age. 2,3 In addition, the flow of diploic veins, which drain the mucosa of the frontal sinuses and facilitate hematogenous spread of infection to the bone and brain, increases in this period. 1,4 It is more prevalent among males, 5 and this may be related to the higher frequency of trauma in this group.…”

“…The most frequent causes include frontal sinusitis and a history of frontal trauma. Less frequent etiologies include insect bites, malignant tumors, acupuncture, 1,3 and intranasal use of cocaine. 2 Causative microorganisms are the same as in acute bacterial rhinosinusitis, 6 mainly Staphylococcus aureus, Staphylococcus epidermidis, and anaerobic bacteria.…”

“…6 Dissemination may occur in 2 ways: directly, through the posterior bone table, which occurs due to the local inflammatory process; or through septic emboli through the diploic veins, which do not have valves that prevent hematogenous spread to the dural sinuses. 3 Intracranial complications include subdural empyema, brain abscess, orbital cellulitis, intraorbital abscess, venous thrombosis, and epidural abscess. 6,7 Diagnosis requires a directed case history, a complete clinical examination, and imaging studies of the affected area, which also allow to assess the presence of potential complications.…”

“…However, when intracranial involvement is suspected, an MRI is considered the gold standard. 1,3,5,6 Differential diagnoses include infected s e b a c e o u s c y s t , d e r m o i d c y s t , l i p o m a , lipoblastoma, frontal sinus mucocele, superficial temporal artery pseudoaneurysm, and malignant tumors. 7 The patient described in this article had no clinical manifestations compatible with intracranial compromise, so a CT scan was initially performed, which showed involvement of the anterior and posterior wall of the frontal sinus.…”

“…2 A late diagnosis and treatment of this condition may result in intracranial complications. 3 For an adequate recovery, intravenous antibiotic therapy accompanied by surgical treatment is required. 4 Here, we describe the case of a male adolescent with Pott's puffy tumor.…”