Tumoración de Pott. A propósito de un caso

Abstract

Presentación de casos clínicos RESUMENSe analiza el caso de un niño con sinusitis frontal, con una forma de presentación poco habitual que, además, padecía una complicación intracraneal grave. Las complicaciones intracraneales de las sinusitis son raras en la actualidad, pero comprenden un amplio rango de entidades graves, como meningitis, abscesos cerebrales y trombosis del seno cavernoso. Se hace hincapié en la importancia del diagnóstico precoz y de un tratamiento empírico inicial adecuado para evitar las posibles complicaciones. Asimismo, cabe enfatizar que una vez producidas estas, requieren un tratamiento médico-quirúrgico intensivo para su resolución. Palabras clave: tumoración de Pott, sinusitis frontal, complicaciones intracraneales. SUMMARYWe present the case of a child with frontal sinusitis, who also suffers from a severe intracranial disease. Although sinusitis intracranial issues are rare nowadays, they include a wide range of serious entities such as meningitis, brain abscesses and thrombosis of the cavernous sinus. We emphasize the importance of early diagnosis and an adequate initial empirical treatment to prevent possible complications. Once they are presented, an aggressive surgical medical treatment is required for its resolution.

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

“…1 Complications in sinusitis are as high as 1 in 10 000 cases. 2 It occurs at all ages, predominantly during adolescence. This is due to the anatomical characteristics associated with this stage of life.…”

“…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.…”

“…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. In the case reported here, a mixed flora of Streptococcus constellatus and Staphylococcus epidermidis was isolated.…”

“…5 A triple antibiotic regimen is suggested to cover grampositive and anaerobic bacteria for 5 to 8 weeks; a potential initial empirical therapy includes vancomycin, third generation cephalosporin, and metronidazole. 2 The drainage of purulent material decreases the mass effect, improves antibiotic penetration, and allows to identify causative microorganisms. 2 The prognosis of Pott's puffy tumor is usually favorable.…”

“…1 Although initially described as a consequence of trauma, Pott's puffy tumor (PPT) is a rare complication of frontal sinusitis, characterized by swelling and edema of the forehead. 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.…”