Pott’s puffy tumour in a pre-adolescent child: the youngest reported in the post-antibiotic era (original) (raw)

Pott’s Puffy Tumor with Intracranial Extension in a Minimally Symptomatic Adolescent

European Journal of Surgery Case Reports

Pott’s puffy tumor is a non-neoplastic, Otolaryngological emergency. It is regarded as a rare clinical condition in the post-antibiotic era and a high index of suspicion is required for its diagnosis. The aetiology is multifactorial and includes sinusitis, infections, trauma, surgery, malignancy, substance abuse as well as contiguous spread along neurovascular bundles. These result in osteomyelitis and subperiosteal abscess formation within the frontal bone. Intracranial involvement can also occur and lead to serious complications. This is the case report of a 12-year old female who developed intermittent forehead swelling, headaches and pyrexia over a 2-week period. Radiological imaging identified changes consistent with a Pott’s puffy tumor complicated by an intracranial abscess. A combined open and endoscopic endonasal approach was used to drain the purulent collections and the patient was placed on antibiotics for a total of six weeks. The management of Pott’s puffy tumor will t...

Neurosurgical implications of Pott’s puffy tumor in children and adolescents

Child's Nervous System, 2014

Introduction Pott's puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis. PPT is potentially severe and can lead to life-threatening intracranial complications. Patients and methods The authors present a series of six pediatric patients diagnosed with PPT and intracranial complications between 1999 and 2012. There were five boys and one girl, and the mean age at diagnosis was 11.8 years. All patients presented with frontal swelling, headache, and fever. Two patients had lowered level of consciousness and severe hemodynamic instability. Results All patients had epidural abscess, and one also presented subdural empyema. Five patients underwent drainage of all associated abscesses, bone resection, and sinusitis treatment. One was treated conservatively with broad-spectrum antibiotics, and no surgical intervention was required. All patients fully recovered their neurologic status, without further complications.

A 9-year-old boy with a nonmalignant forehead tumor – a rare case of pediatric Pott’s puffy tumor

BMC Pediatrics

Background Pott’s puffy tumor (PPT) is a rare and potentially deadly complication of frontal sinusitis consisting of subperiosteal abscess and osteomyelitis of the frontal bone. Case presentation We report the case of a 9-year-old boy who presented with fever and soft tissue swelling of the forehead. Magnetic resonance imaging (MRI) depicted an abscess in the subcutaneous tissue frontally and an epidural empyema, while a cranial computed tomography (CT) scan revealed bone erosion as a sign of osteomyelitis. The patient was treated accordingly. Conclusions This rare condition is essential to keep in mind as it needs a multidisciplinary approach and relevant imaging to start proper treatment and thus decrease the risk of intracranial complications.

Pott's puffy tumour: still not an eradicated entity

Childs Nervous System, 2001

Pott's puffy tumour is an infrequent entity characterised by one or more subperiosteal abscesses associated with frontal bone osteomyelitis. Although cases in patients of all ages have been reported, teenagers are the most frequently affected. Early diagnosis and aggressive treatment are essential because of the high risk of severe neurological complications, such as epidural abscess, subdural empyema, and secondary septic thrombosis of the dural sinuses. This paper describes the case of a patient with a subperiosteal abscess resulting from sinusitis, with orbital and intracranial extension, and subsequent neurological complications. Despite modern methods of diagnosis and treatment, 13 new cases have been published in the last 5 years; in at least 3 (23%) of these cases there were serious neurological complications. Upper respiratory infections and sinusitis are leading causes of visits to the emergency department in the paediatric age group; however, no risk factors for poor outcome have so far been identified in any of these patients.

Pott ’ s Puffy Tumor-A Case Report and Brief Review of Literature

2019

Pott’s puffy tumour is a subperiosteal abscess with associated osteomyelitis arising from the frontal sinus. Aetiology for the same has been reported as post traumatic, sequelae to acute and chronic frontal sinusitis and even insect bites. However, in the post antibiotic era, the incidence of this condition has declined significantly. This condition has a high risk of intracranial complications such as abscess formation and meningitis if not recognised early and appropriately treated. Even though it is more common in the paediatric age group, there are few cases reported in the adult population as well [1]. In this article we report a case of Pott’s puffy tumour in a 30year old man and review the relevant literature regarding the best management principles.

Pott ' s Puffy Tumour : A Rare But Sinister Cause of Periorbital Oedema In A Child

2017

Introduction: Pott's puffy tumour (PPT), first described by Percival Pott in 1760, refers to a doughy, indolent swelling over the forehead caused by an underlying subperiosteal abscess of the frontal bone. Osteomyelitis of the frontal bone associated with subperiosteal abscess collection is termed Pott’s puffy tumour. It typically affects adolescent male subjects with frontal sinusitis and presents to ENT or neurosurgeons. However, we describe an unusual case occurring in a 9-year-old child and presenting with periorbital oedema with frontal sinusitis.

Pott’s Puffy Tumor: An Uncommon Clinical Entity

Case Reports in Pediatrics, 2012

Although first described in 1760, Pott’s puffy tumor is a lesser known clinical entity. Often seen as a complication of frontal sinusitis, Pott’s is a frontal bone osteomyelitis with an associated subperiosteal abscess. Patients present with a fluctuant swelling of the scalp. The diagnosis is often confirmed with computed tomography (CT). Prompt surgical and medical treatments are the rule as there is the potential for significant morbidity if not quickly diagnosed and treated. Herein, we describe the presentation, diagnosis, and treatment of an 8-year-old female presenting with Pott’s puffy tumor.

Pott's Puffy Tumor: It's not a Tumor but it Can be Lethal (2 Cases Report)

Scholars journal of medical case reports, 2022

The Pott's puffy tumor has become an infrequent entity since the advent of antibiotic therapy. It is defined as a subperiosteal abscess arising from frontal bone osteomyelitis. We report two cases of PPT due to intreated frontal sinusitis and confirmed by computed tomography scan. Early surgery associated with long-term intravenous antibiotics is required to obtain a good recovery and prevent life-threatening intracranial complications.

Pott′s puffy tumour: A case report

Annals of African Medicine, 2008

A 10-year-old girl presented with an episode of seizure following osteomyelitis of the frontal bone and subperiosteal abscess due to frontal sinusitis. CT scan confirmed osteomeyelitis of the frontal bone and subperiosteal abscess. At surgery, the subperiosteal abscess and contiguous subdural abscess was drained and sequestrectomy of the affected frontal bone done. Broad spectrum antibiotics and anticonvulsant were given for 4 weeks. The patient recovered without residual problems and has remained well at 5 years of follow up. Pott's puffy tumor is now relatively uncommon and associated seizure is unusual. Early diagnosis and prompt treatment is necessary to avoid severe neurological complications and sequelae.

Pott’s Puffy Tumor - Overview of case series

Jornal Memorial da Medicina, 2021

Pott’s puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis that has been neglected or partially treated, resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis, which can lead to life-threatening intracranial complications, such as epidural/subdural empyema, cerebral abscess and meningitis. Given this, the purpose of the present study was to gather the most diverse cases reported together to highlight the main treatment methods. Methods: It is a narrative review, starting from the search in the database PubMed, Lilacs and Scielo from 2010 to 2020, which resulted in 34 scientific articles. The search focused on obtaining data on new approaches and treatments established for Pott’s puffy tumor. Results: 34 articles were included which described 58 patients with a swollen Pott tumor, occurring predominantly in male adolescents, with streptococci (26,1%) as the main etiologic agent. Approximately 84% of all patients were male s...