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Not quite Pott's puffy tumour
Rasads Misirovs1, Rohit Gohil2, Peter Ross1
1Department of Otolaryngology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland, UK.
BMJ Case Reports
|April 27, 2018
Summary
Pott's puffy tumour (PPT) is a rare complication of frontal sinusitis. This case highlights a similar presentation without frontal bone osteomyelitis, emphasizing accurate diagnosis for effective treatment.
Area of Science:
- Otolaryngology
- Neurosurgery
- Radiology
Background:
- Pott's puffy tumour (PPT) is a subperiosteal abscess with frontal bone osteomyelitis, typically seen in children.
- It is a rare but serious complication of frontal sinusitis.
Observation:
- A 63-year-old male presented with a forehead swelling mimicking PPT.
- The patient was systemically well, unlike typical PPT cases.
- Previous surgery may have facilitated abscess extension.
Findings:
- CT scans evaluated for intracranial complications like epidural, subdural, and brain abscesses.
- Emergent surgical drainage and prolonged antibiotics were administered.
- Recurrence in the frontal sinus required further intervention, including a Lothrop procedure and endoscopic sinus surgery.
Implications:
- This case underscores the importance of differentiating PPT from similar conditions, especially when frontal bone osteomyelitis is absent.
- Accurate diagnosis is crucial for appropriate management and surgical planning.
- The case highlights the potential for abscess recurrence and the need for comprehensive surgical treatment.