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Published on: December 19, 2020
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Pott's puffy tumor in the post-COVID era
Siegfried J Adelhoefer1, Eric M Jackson2, Mari Groves2
1Division of Pediatric Neurosurgery, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA. jason.adelhoefer@gmail.com.
Summary
Pott's puffy tumor (PPT) is a serious complication of frontal sinusitis. Early surgery and antibiotics led to a 92% full recovery rate in a recent US cohort.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Disease
Background:
- Pott's puffy tumor (PPT) is an intracranial complication of frontal sinusitis, potentially causing severe neurological issues.
- Symptoms include headache, periorbital swelling, and in some cases, seizures or thrombosis.
- While historically linked to sinusitis, an increase in PPT cases has been noted post-COVID-19.
Purpose of the Study:
- To analyze the demographics, clinical presentation, and outcomes of patients with Pott's puffy tumor.
- To investigate potential links between PPT and COVID-19.
- To contribute data on the largest reported PPT cohort in the USA.
Main Methods:
- Retrospective review of 24 patients treated at a major US tertiary-referral center from 2020 to 2024.
- Data collected included clinical presentation, diagnostic workup, surgical approach, and recovery status.
- Primary outcome was recovery status (full, partial, death).
Main Results:
- 24 patients (17 boys) presented with sinusitis (75%), periorbital swelling (71%), and fever (63%); 33.3% had seizures.
- Most patients underwent bifrontal craniotomy and frontal sinus exenteration.
- 92% achieved full recovery, with one partial recovery and one death (due to unrelated malignancy).
Conclusions:
- Early surgical intervention and broad-spectrum antibiotics are crucial for treating Pott's puffy tumor.
- A causal link between COVID-19 and PPT was not identified in this cohort.
- Increased PPT awareness is vital for optimal patient care in the post-COVID era.
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