Pott's puffy tumour and intracranial complications of frontal sinusitis in pregnancy

J Laryngol Otol. 2013 Jan;127 Suppl 1:S35-8. doi: 10.1017/S0022215112001673. Epub 2012 Aug 15.

Abstract

Introduction: A Pott's puffy tumour is a subperiosteal abscess and osteomyelitis of the frontal bone secondary to frontal sinusitis. Intracranial complications are seen in approximately 40 per cent of cases and are potentially life-threatening; such complications have not previously been reported in pregnancy.

Case report: A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. Imaging confirmed Pott's puffy tumour with right-sided epidural empyema and periorbital cellulitis. A multidisciplinary team was involved in the patient's management. Intravenous antibiotics were commenced and initial percutaneous drainage through the frontal sinus skin was performed, followed by endoscopic sinus drainage. A caesarean section was performed 3 days later. Complete resolution of the sinus and intracranial collections was noted on imaging performed six weeks later.

Conclusion: This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Catheterization
  • Ceftriaxone / administration & dosage
  • Ceftriaxone / therapeutic use
  • Cesarean Section
  • Drainage
  • Drug Therapy, Combination
  • Endoscopy
  • Female
  • Frontal Sinusitis / complications*
  • Frontal Sinusitis / drug therapy
  • Frontal Sinusitis / surgery
  • Headache / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Meropenem
  • Orbital Cellulitis / etiology
  • Patient Care Team
  • Pott Puffy Tumor / etiology*
  • Pott Puffy Tumor / pathology
  • Pott Puffy Tumor / therapy
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / etiology*
  • Pregnancy Complications, Infectious / surgery
  • Streptococcal Infections / complications*
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / surgery
  • Thienamycins / administration & dosage
  • Thienamycins / therapeutic use
  • Treatment Outcome
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Vancomycin
  • Ceftriaxone
  • Meropenem