Management of a Pott puffy tumor: Case report and literature review.

Int J Surg Case Rep

Department of Otolaryngology, Head and Neck Surgery, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Published: October 2024

AI Article Synopsis

  • Pott's puffy tumor (PPT) is a rare condition primarily affecting children and teens, characterized by frontal bone osteomyelitis and a subperiosteal abscess, necessitating urgent treatment to avoid serious complications.
  • A case study of a 29-year-old woman revealed a post-traumatic periorbital swelling due to this condition, which was confirmed via CT scan and treated with surgery and antibiotics.
  • Effective management includes prompt diagnosis through imaging, immediate intravenous antibiotics, and potential surgical interventions to prevent life-threatening complications associated with PPT.

Article Abstract

Introduction And Importance: Frontal bone osteomyelitis associated with a subperiosteal abscess is known as Pott's puffy tumor. Pott puffy tumor (PPT) is a rare entity that mainly affects children and adolescents. It is less common in adults, accounting for 30 % of cases, and predominates in men. The therapeutic management of Pott's puffy tumor is an emergency and is based on a combination of antibiotic therapy and surgical treatment to prevent the emergence of intracranial complications and reduce morbidity and mortality.

Case Presentation: We report the case of a 29-year-old female patient, who consulted our ENT (ear, nose, and throat) department for a post-traumatic periorbital swelling. CT scan confirmed osteomyelitis of the frontal bone and subperiosteal abscess. The patient underwent a combined surgical drainage with antibiotics. The aim is to describe an effective management of this clinical case.

Clinical Discussion: This condition presents as a subperiosteal/subgaleal abscess creating a frontal swelling, with osteomyelitis of the frontal bone most often secondary to frontal sinusitis. The most feared complications are intracranial, which can be life-threatening. Imaging is the key to positive diagnosis, as the evolution and prognosis of TPP depend on rapid management. A CT scan of the head is the examination of choice to confirm the diagnosis. Antibiotic therapy should be started as soon as possible, it is usually administered by intravenous injection. Surgical management may be limited to percutaneous drainage by needle or transnasal endoscopy or trephination, sometimes including trimming of the subperiosteal/subgaleal abscess. In the case of intracranial complications, a craniotomy may be necessary.

Conclusion: The Pott's puffy tumor is little-known complication, usually secondary to untreated or poorly treated sinusitis. As a result of this poor understanding, the condition can lead to complications, especially intracranial ones, which increase morbidity and mortality.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408766PMC
http://dx.doi.org/10.1016/j.ijscr.2024.110241DOI Listing

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