Adult Pott's Puffy Tumor in the ED

Pott's puffy tumor (PPT) is a rare but potentially serious complication of sinonasal infection characterized by frontal bone osteomyelitis with an associated subperiosteal abscess. Although traditionally associated with adolescents, it can occur in adults and may present in the absence of systemic features of infection. This can create a diagnostic challenge in the ED, where frontal swelling may initially appear to represent a more superficial or uncomplicated process. We present a case of a 50-year-old man who attended a district general ED with a prolonged history of sinonasal symptoms and a previous odontogenic infection, followed by the development of significant frontal swelling. Despite extensive local pathology, there were no systemic, neurological, or visual abnormalities. The diagnosis prompted early antimicrobial treatment and urgent referral for specialist surgical management, with an uncomplicated recovery. This case demonstrates the importance of recognizing PPT as a potential complication of sinonasal and dental infection in adults. Emergency clinicians should remain alert to the significance of frontal swelling, even in patients who appear systemically well. Early recognition, appropriate initial management, and timely specialist transfer are essential to prevent potentially serious intracranial complications.