Department of Otolaryngology, NHS Grampian, Aberdeen, UK
Department of Otolaryngology, NHS Grampian, Aberdeen, UK.
BMJ Case Rep. 2022 Mar 4;15(3):e247325. doi: 10.1136/bcr-2021-247325.
Pott's puffy tumour (PPT) is a rarely seen, but highly important, complication of frontal sinusitis. Early recognition followed by prompt imaging and treatment of this condition are essential to improve patient outcomes and prevent complications. This case report describes an atypical presentation of radiologically confirmed PPT in a boy who presented with a 2.5-week history of progressive frontal headache and midline frontal swelling. Flexible nasendoscopy revealed no acute findings. Prompt CT imaging confirmed the diagnosis and early surgical intervention via endoscopic approach with aggressive antibiotic therapy led to good recovery. This case highlights the need to remember PPT in assessing any child or adolescent with a new forehead swelling, with or without sinusitis symptoms. If there is strong clinical suspicion, further imaging should not be delayed. Surgical intervention should be performed as early as possible to prevent intracranial complications; antibiotics alone are not sufficient.
波特氏脓肿(Pott's puffy tumour,PPT)是额窦炎少见但非常重要的并发症。早期识别,及时影像学检查和治疗对改善患者预后和预防并发症至关重要。本病例报告描述了一例男孩经影像学证实的不典型额窦炎 PPT,其表现为进行性额头痛和中线额部肿胀,病程 2.5 周。软性鼻内镜检查未见急性发现。及时 CT 成像确认了诊断,通过内镜方法进行早期手术干预,并给予积极的抗生素治疗,患者恢复良好。本病例强调了在评估任何新发额部肿胀的儿童或青少年时,无论是否伴有鼻窦炎症状,都需要考虑 PPT。如果临床高度怀疑,不应延迟进一步影像学检查。应尽早进行手术干预,以预防颅内并发症;仅使用抗生素是不够的。