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Background: Pott's puffy tumor (PPT) is an uncommon infection involving the frontal bone, first described by Sir Percival Pott more than 250 years ago. It can present with intracranial extension and serious neurological morbidity. Incontinentia pigmenti (IP) is a rare inherited genodermatosis that is lethal prenatally in males and manifests clinically in females. IP is associated with recurrent infections and immune dysfunction/suppression., Methods: We report a case of Pott's puffy tumor presenting in a child with IP. We also performed a literature review of reported cases of PPT associated with immune dysfunction. We discuss the clinical presentation, diagnosis, and management of these lesions., Results: We identified 12 cases of PPT associated with immune dysfunction/suppression. Diabetes was the most commonly identified cause followed by iatrogenic immunosuppression. Surgery is the standard treatment for managing PPT and the management of PPT with and without intracranial involvement, particularly in the context of underlying immune dysfunction/suppression, is discussed., Conclusion: PPT remains a rare but not infrequent diagnosis, often requiring neurosurgical intervention. Immune dysfunction/suppression is an additional risk factor that may predispose to PPT. Early and aggressive management should be instituted for optimal outcome., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

A rare complication of frontal sinusitis includes Pott's puffy tumor. It manifests as a swelling of the forehead due to the presence of a subperiosteal abscess secondary to osteomyelitis of the frontal bone. A timely diagnosis allows for an early, intensive medical and surgical treatment, which is critical to prevent serious intracranial complications. Here we describe the case of a 12-year-old boy with Pott's puffy tumor as a complication of pansinusitis. This case was a diagnostic challenge; however, a timely treatment allowed for a favorable clinical course., (Sociedad Argentina de Pediatría.)

Pott's puffy tumor (PPT) describes forehead swelling with associated frontal bone osteomyelitis and a subperiosteal abscess (SPA) requiring a high suspicion index for optimal outcomes. PPT is a life-threatening complication of frontal sinusitis typically found in adolescents. Our case is one of the youngest in the literature. This report describes a 3-year-old patient who developed multifocal abscesses in the epidural space with frontal and orbital SPA, requiring surgical intervention. Additionally, her course was complicated by a superior sagittal venous thrombosis, a complication commonly associated with PPT. We present an unusual case of orbital SPA and aim to highlight a life-threatening pediatric condition that is often underrecognized., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest.

A 10-year-old boy presented with headache, fever, left-sided ptosis, and right-sided forehead soft tissue swelling. There was no recent history of trauma or infection. The patient had a large, fluctuant mass on the right side of his forehead, upgaze restriction, left-sided ptosis, and bilateral optic disk edema. Magnetic resonance imaging of the brain showed a frontal bone extradural fluid collection superficial to the superior sagittal sinus in keeping with an epidural abscess. There were multiple venous thromboses and thickening and enhancement of the dura, compatible with meningitis. There was right sphenoid sinusitis. This patient had Potts puffy tumor, a rare diagnosis associated with a forehead swelling from frontal bone osteomyelitis and subperiosteal abscess. It is seen in the pediatric population in association with sinusitis or trauma. Antibiotics, anticoagulation, and acetazolamide were initiated, and the epidural abscess was evacuated. The symptoms and signs resolved with treatment., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: Pott's puffy tumor (PPT) is a rare clinical entity characterized by osteomyelitis of the frontal bone with subperiosteal abscess collection. The frequency of reported cases of PPT in the literature has increased in recent years. Previous reviews of PPT exist primarily in the form of small, retrospective case series and anecdotal case reports. Therefore, the aim of this study is to provide the literature's largest comprehensive, up-to-date review of the essential clinical findings, diagnostic modalities, microbiologic considerations, and treatment approaches utilized in the management of PPT, both in pediatric and adult populations., Materials and Methods: We searched MEDLINE, PubMed, and Embase databases for English-language studies published from January 1950 through January 30, 2022. The authors reviewed all cases of PPT, focusing specifically on those describing therapeutic management of PPT. A total of 321 patients were included, consisting of 318 patients (from 216 articles) and an additional 3 adult cases from our institution., Results: PPT most often results from untreated rhinosinusitis, as well as direct head trauma, substance use, and odontogenic disease. Infections are classically polymicrobial with an anaerobe-predominant microbiome. Both CT and MRI imaging modalities are commonly obtained for presurgical assessment of sinusitis and intracranial extension. The core of treatment is an early and aggressive approach to prevent long-term complications. A significant association exists between surgical management and clinical outcomes for patients with PPT. Recent literature suggests endoscopic sinus surgery is essential for successful disease resolution., Conclusions: PPT is an important and relatively morbid disease process that is often underrecognized and misdiagnosed at presentation due to its variable clinical presentation. Management of PPT includes both antimicrobial therapy and surgical intervention. Determination of the optimal approach depends on patient clinical features including age, history of prior endoscopic sinus surgery, and presence of intracranial involvement on presentation. An individualized, targeted, and interdisciplinary approach to the treatment of PPT is critical for successful disease resolution., Competing Interests: Declaration of competing interest None., (Published by Elsevier Inc.)

Competing Interests: Competing interests: None declared.

A 27 year old female presented to the emergency department with intermittent central forehead swelling over several months associated with a headache. She was admitted under the medical team as having had a suspected allergic reaction but the diagnosis of a Pott's Puffy Tumour was quickly made and confirmed through CT and MR imaging. This uncommon condition is related to sinusitis leading to localised abscess formation with osteomyelitis and a subsequent swollen appearance over the affected facial sinus. This patient's sinus abscess extended into the epidural space and caused destruction of the anterior and posterior walls of the frontal sinus. The patient was managed with intravenous antibiotics, analgesia and referral to the local ENT team for surgical intervention.

Background: The Streptococcus anginosus group (SAG, S. anginosus, S. intermedius and S. constellatus) are often associated with severe disease and abscess formation. In our institution, we observed an apparent increase in frequency of intraorbital and intracranial infections resulting from SAG at Texas Children's Hospital. We undertook a retrospective review to describe the frequency and clinical features of these infections., Methods: We reviewed the database of the microbiology laboratory at Texas Children's Hospital from 2011 to 2018 for SAG-positive cultures. Cases included were those associated with (1) either otitis media or sinusitis and (2) Pott's puffy tumor, orbital abscesses, mastoiditis, epidural abscesses, subdural empyema, brain parenchymal abscesses or dural enhancement by imaging. The number of overall diagnoses were determined using diagnostic codes and used to estimate the proportion of disease caused by SAG., Results: Ninety-five cases were identified meeting inclusion criteria. The median age of patients was 11.4 years, and 75.8% were previously healthy. S. intermedius was most commonly isolated (80%) followed by S. constellatus (12.6%) and S. anginosus (7.4%); 50.5% of cases were polymicrobial. Among polymicrobial cases, Staphylococcus aureus was most frequently isolated. All patients underwent surgical intervention. 8.4% of patients experienced persistent neurologic deficits. We observed a significant increase in disease incidence during the study period; in addition, the overall proportion of all intracranial infections caused by SAG increased., Conclusions: Complications of otitis media and sinusitis caused by SAG are associated with substantial morbidity. These infections are becoming increasingly common at our center although the precise reason for this temporal trend is unclear.

Objectives: Pott's puffy tumor (PTT) is a frontal subperiosteal abscess associated with underlying frontal osteomyelitis. The purpose of the present study was to assess the rate of intracranial involvement in pediatric and adolescent patients with PPT and to discuss the diagnostic workup and the therapeutic features of this pathology., Methods: We searched Web of Science, PubMed and MEDLINE from 1998 to 2018. The search focused on papers concerning the diagnostic procedure and therapeutic management of PTT. Statistical techniques were not used., Results: We included 53 articles that described 92 pediatric and adolescent patients with PPT. The overall rate of intracranial complications was found to be 72%. Most authors used computed tomography for the diagnosis of PTT and its complications, either alone or in combination with magnetic resonance imaging. In 50% of cases, an endoscopic endonasal approach is used for the management of the underlying acute or chronic sinusitis., Conclusions: On the basis of the available literature, it seems that the incidence rate of intracranial involvement in patients with PPT is quite high. Early diagnosis using the appropriate imaging raise the possibility of good recovery. Concerning the therapy of PTT, endoscopic sinus surgery could be considered as a valuable technique. The vast majority of patients treated appropriately recover without long-term neurologic complications and sequelae., Level of Evidence: 4 Laryngoscope, 130:225-231, 2020., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

In this report, we describe an uncommon presentation of a Pott's puffy tumor, which is defined as a subperiosteal abscess related to a chronic frontal sinusitis. This condition has become rare in our part of the world because of the widespread use of antibiotics. Clinical history, investigations, and management are presented., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Pott's puffy tumour (PPT) is characterised by a subperiosteal abscess associated with osteomyelitis of the frontal bone-a rare complication of frontal sinusitis, more common in the paediatric population. We describe a case mimicking PPT, where abscess extension was facilitated by previous surgery. Usually patients with PPT would be systemically unwell, but our patient, a 63-year-old Caucasian man, was systemically well with a large swelling of his forehead. A CT was performed to evaluate possible intracranial and intracerebral complications such as epidural, subdural and brain abscesses. Emergent surgical drainage was performed with prolonged administration of antibiotic therapy. 12 weeks later, he had recollection in the frontal sinus requiring incision and drainage. 6 weeks afterwards, he underwent planned Lothrop procedure and endoscopic sinus surgery. Although clinically the patient presented with overwhelming features of PPT, we emphasise that PPT involves osteomyelitis of frontal bone, which is absent in our case., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Langherans' cell histiocytosis (LCH) is a rare disease mostly affecting children in the first decade of life. As clinical presentation is extremely heterogenous, a prompt diagnosis may be challenging, sometimes leading to a diagnostic delay, especially when the disease involves a single site. Herein, we report a case of a child with an unusual presentation of (LCH) mimicking a Pott puffy tumor with extracranial and epidural abscesses, surgically treated. Through this unique case we summarize possible manifestations of LCH with bone involvement and we underline the importance of considering possible complications due to bone erosions such as infection, to avoid a misdiagnosis.

A 45 years old male patient presented with recurrent abscess of the nasal root and right periorbital tissue. The incision and drainage were performed repeatedly, and anti-infection had poor effect of treatment. Previous history of sinusitis surgery. Nasal cavity and frontal sinus infections and abscesses were treated in other hospitals. CT showed enhanced patchy foci and abscesses on the right temporal side, frontal, periorbital and nasal roots. Repeated discharge of purulent secretions during hospitalization in our hospital prompted Klebsiella pneumoniae infection. After the patient was discharged from the hospital, he was diagnosed with Pott's tumor by repeated consultation with the literature.

Competing Interests: Competing interests: None declared.

Background: Pott's puffy tumour is characterized by a fluctuate swelling of the frontal region as a result of osteomyelitis of the frontal bone. This inflammatory lesion may propagate endocranially, resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis, and frontal lobe abscess of the brain., Case Report: We present an unusual case of a 33-year-old man suffering from Pott's puffy tumour whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess. We confirmed the diagnosis by contrast-enhanced computed tomography scanning and magnetic resonance imaging of the head. After intense antibiotic treatment, we performed a combined endoscopic and external surgical approach with drainage of abscesses, evacuation of pus and bone sequestrate and excision of fistulous lesion. The treatment was prolonged with four weeks' antibiotic administration., Conclusion: Subperiosteal abscess of the frontal bone is an extremely rare complication of frontal sinusitis. This lesion may propagate endocranially, resulting in dangerous intracranial inflammatory lesions. Early diagnosis, medication and surgical therapy are very important in reducing morbidity and mortality.

A 39-year-old male was admitted to the emergency room with a swelling of the forehead. He had a fever since 5 days and increasing pain on his forehead. He was diagnosed with Pott's puffy tumour, a complication of sinusitis.

Seizures is a comparatively common neurologic unwellness in children that has significant implications for development, parents, and society. The etiologic categories of seizures involve idiopathic, symptomatic, and cryptogenic. Pott puff tumor is a rare cause of seizures. The authors present a rare cause of the seizures.A 12-year-old boy presented with seizures. On physical examination there was swelling on his glabella. Laboratory testing indicated leukocytosis and increased C-reactive protein, and microbiological testing showed the presence of pathogenic streptococcus sp. Brain magnetic resonance imaging was performed. T1-weighted image with gadolinium enhancement revealed frontal bone defects and subcutaneous abscess and left frontal swelling. On the diffusion-weighted imaging, the abscess has relatively homogeneous increased signal intensity b1000. The apparent diffusion coefficient map reveals low intensity. Intracranial spread also showed contrast-enhanced image (). Magnetic resonance imaging typically reveals an intracranial abscess.Pott puffy tumor is an unusual clinical existence characterized by osteomyelitis of the frontal bone. The very common symptoms are headache, swelling fever, and nasal discharge. Frontal sinus infection may induce osteomyelitis, subperiosteal, and epidural abscess.

Objectives: Pott puffy tumor (PPT) is defined as soft tissue swelling of the forehead due to subperiosteal edema, accumulation of pus, or granulation tissue. It is associated with osteomyelitis of frontal bone secondary to frontal sinusitis. Pott puffy tumor can be complicated by preseptal and orbital cellulitis and intracranial infection., Methods: Six patients diagnosed with and treated for PPT in Pediatric Clinic of Uludag University Faculty of Medicine from 2010 to 2015 were reviewed retrospectively. Age, sex, presenting symptoms and signs, laboratory and radiological findings, as well as intracranial complications and treatment modalities of all patients were evaluated., Results: The authors present 6 pediatric patients of PPT, 5 males and 1 female with a mean age of 11 years (age range, 7-18 years). All patients presented with headache, fever, and tender frontal swelling. Two of the patients had epidural abscess and 1 had preseptal orbital cellulitis in addition to PPT. All of them had computed tomography scan and/or magnetic resonance imaging. Endoscopic sinus surgery was performed in 4 patients and 2 patients underwent neurosurgical intervention with antibiotherapy., Conclusions: Pott puffy tumor may be associated with potentially dangerous intracranial complications. Early diagnosis and treatment are essential to reduce morbidity and mortality. Imaging plays an important role in the diagnosis of the disease and the detection of its complications.

A young adolescent patient presented to the emergency department with forehead and eyelid swelling after a week of nasal discharge that was suspicious for Pott's puffy tumor. Point-of-care ultrasound facilitated rapid diagnosis and initiation of treatment for a concerning and rare complication of sinusitis, confirmed by computed tomography scan.

Pott's puffy tumor (PPT) is a rare complication of sinusitis characterized by subperiosteal abscess and osteomyelitis of the frontal bone. Early diagnosis and treatment is vital before it causes intracranial complications such as subdural empyema or brain abscess. Herein we describe the case of a 12-year-old patient who developed preseptal cellulitis and PPT, and was successfully treated with abscess drainage, sinus surgery and long-term antibiotic therapy., (© 2015 Japan Pediatric Society.)

Metastasis of the lung adenocarcinoma to the paranasal sinuses is a rare clinical entity. We present a 75-year-old male patient who presented with swelling of the forehead and left upper eyelid with proptosis in left eye due to metastasis from lung adenocarcinoma. It appears as a puffy swelling of the forehead like a Pott's puffy tumor. Pott's puffy tumor is a subperiostal abscess of the frontal bone associated with osteomyelitis and usually occurs as a complication of sinusitis or trauma.

We present the case of a child with frontal sinusitis, who also suffers from a severe intracranial disease. Although sinusitis intracranial issues are rare nowadays, they include a wide range of serious entities such as meningitis, brain abscesses and thrombosis of the cavernous sinus. We emphasize the importance of early diagnosis and an adequate initial empirical treatment to prevent possible complications. Once they are presented, an aggressive surgical medical treatment is required for its resolution.

Malignant lymphoma of the paranasal sinuses and nasal cavity is very rare and can mimic those of infectious, non-lymphomatous neoplastic and granulomatous process in their initial presentation, thus delaying its diagnosis. This report describes a case of unilateral frontal sinus B-cell lymphoma presenting as Pott's puffy tumour. Key features to differentiate the two conditions are discussed. A 61-year-old woman presented with 4 weeks history of a gradually enlarging right-sided forehead swelling, which was smooth and firm with no tenderness, fluctuation or overlying skin changes. Initial computed tomography (CT) of the paranasal sinuses revealed a mildly opacified right frontal sinus with an overlying soft tissue swelling. A repeat CT scan one week later showed evidence of osteomyelitis of the medial wall of the right frontal bone and orbit, suggesting diagnosis of Pott's puffy tumour. A third CT scan was performed as the swelling continued to enlarge despite antibiotics, which demonstrated a collection over the frontal sinus. No pus was found from a frontal sinus trephine. Histopathologic analysis of the frontal sinus biopsy showed diffuse large B cell lymphoma. The patient was treated successfully with 6 cycles of chemotherapy. In conclusion, it is not easy to differentiate Pott's puffy tumour from frontal sinus lymphoma at their initial presentation. With clearer understanding of both conditions, we can raise the index of suspicion among clinicians of the possibility of frontal sinus lymphoma even when evidence of osteomyelitis is present, therefore prompting earlier tissue biopsies for confirmation of diagnosis., (Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

We describe the case of a 5-year-old girl with a Pott puffy tumor on her forehead. Computed tomography confirmed frontal sinusitis and an epidural abscess. This case is unusual in that the patient's age at presentation was younger than the age when the frontal sinuses are believed to develop.

A 14-year-old adolescent boy experienced a nonsevere infection of the upper respiratory tract. After 10 days, he developed headache, intermittent vomiting, and fever. A sudden prominent swelling of the forehead occurred, and his general condition deteriorated. Cranial computed tomography showed a subdural empyema and subperiosteal abscess owing to osteomyelitis of the frontal bone. Surgical drainage of the subdural empyema and the subperiosteal abscess was performed, and appropriate long-term antibiotic therapy was initiated. The swelling of the forehead caused by a subperiosteal abscess with osteomyelitis of the frontal bone after frontal sinusitis or trauma is known as Pott's puffy tumor. This case demonstrates that swelling of the forehead in the presence of upper respiratory tract infection should lead to prompt evaluation for complications., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To study the etiology, clinical features and treatment outcomes of pediatric Pott's puffy tumor (PPT)., Methods: This retrospective study was carried by reviewing medical case record of pediatrics PPT cases admitted to our hospital from January 2010 to august 2011. Data regarding the patient's demographic details, presenting symptoms and signs, etiology, laboratory findings, imaging findings, management, complications and outcomes of treatment were collected and analyzed., Results: A total of five cases of PPT were found. Three were male and two were female with a mean age of 11.6 years. All patients presented with headache, fever and tender forehead swelling. Nasal polyps and discharging sinuses over forehead were present in one case and one case had preseptal orbital cellulites in addition to PPT. None of the patient had intracranial complications. Three cases (60%) were secondary to acute frontal sinusitis, one case was as complication of chronic sinusitis and one case was because of trauma. Contrast enhanced Computerized tomography (CECT) demonstrated features of acute sinusitis in 3 cases, sinonasal polyp in one, fracture of anterior table of frontal bone in one case, subperiosteal collection and erosion of anterior table frontal bone in all cases. All patients required surgical intervention; Endoscopic approach 2 cases (40%), combined approach in 2 cases (40%) and external approach in one case (20%) in addition to aggressive antibiotic treatment. There was purulent discharge in frontal sinuses in all cases. In 2 cases (40%), culture of pus drained during surgery was positive; one case methicillin resistant Staphylococcus aureus sensitive to vancomycin, other Pseudomonas aeruginosa sensitive to ceftazidime and amikacin. All cases improved with treatment. There were no postoperative complications or facial cosmetic deformity except facial scar in three cases. The average hospital stay was two weeks and ranged from 10 days to 21 days. All patients received antibiotics for 6-8 weeks to treat osteomyelitis of the frontal bone. The average length of follow up was 9 months (range 6-18 months). All patient are doing well and are under regular follow up., Conclusions: PPT is a complicated infection of frontal sinusitis and trauma that requires broad spectrum antibiotics and surgical treatment. Diagnosis is made by high clinical suspicion of this condition and confirmed by CECT. Early treatment results in favorable outcomes and decreases the risk of further complications., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)