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Scalp abscess--a cautionary tale

Nora F Nugent1, Michael Murphy, Jason Kelly

  • 1Department of Plastic Surgery, Cork University Hospital, Wilton, Cork, Ireland. noranugent@gmail.com

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|March 2, 2010
PubMed

Insights

Frontal sinusitis can rarely spread into the skull, causing serious intracranial complications like osteomyelitis. Early investigation and prompt surgical and antimicrobial treatment are crucial for patients with persistent symptoms.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Frontal sinusitis, an infection of the frontal sinuses, can rarely lead to intracranial complications.
  • Transcranial extension of infection is a rare but significant clinical entity.

Observation:

  • A 21-year-old male presented with a persistent scalp abscess.
  • This initially suggested a localized issue but led to the diagnosis of skull vault osteomyelitis and extradural abscesses.
  • The underlying cause was identified as frontal sinusitis.

Findings:

  • The case highlights a rare instance of frontal sinusitis causing extensive intracranial complications.
  • Skull vault osteomyelitis and extradural abscesses were confirmed secondary to the sinus infection.
  • Delayed diagnosis can lead to severe morbidity.

Implications:

  • Patients with prolonged or unusual symptoms, especially with a history of sinusitis or head trauma, require thorough investigation for potential intracranial complications.
  • Prompt surgical intervention and appropriate antimicrobial therapy are essential for managing these severe infections.
  • This case underscores the importance of considering rare but serious complications in the differential diagnosis of seemingly localized infections.

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