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儿童颅骨骨膜下脓肿(Pott 氏膨出肿)的罕见表现:我们的近期经验及文献复习。

Unusual Presentation of Pott's puffy tumour in a child: our recent experience and review of the literature.

机构信息

Department of Otolaryngology, NHS Grampian, Aberdeen, UK

Department of Otolaryngology, NHS Grampian, Aberdeen, UK.

出版信息

BMJ Case Rep. 2022 Mar 4;15(3):e247325. doi: 10.1136/bcr-2021-247325.

Abstract

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.

摘要

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。

相似文献

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Pott's puffy tumor in pediatric age group: a retrospective study.儿童期波特氏浮肿性肿瘤:一项回顾性研究
Int J Pediatr Otorhinolaryngol. 2012 Sep;76(9):1274-7. doi: 10.1016/j.ijporl.2012.05.018. Epub 2012 Jun 15.
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Not quite Pott's puffy tumour.不太像波特氏浮肿性肿瘤。
BMJ Case Rep. 2018 Apr 25;2018:bcr-2018-224463. doi: 10.1136/bcr-2018-224463.
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Pott's puffy tumor: A rare complication of sinusitis. A case report.波特氏膨出肿:鼻窦炎的罕见并发症。病例报告。
Arch Argent Pediatr. 2024 Aug 1;122(4):e202310151. doi: 10.5546/aap.2023-10151.eng. Epub 2024 Feb 1.

本文引用的文献

2
Pott's puffy tumor in children: A review of the literature.儿童的波特氏膨出性脓肿:文献回顾。
Laryngoscope. 2020 Jan;130(1):225-231. doi: 10.1002/lary.27757. Epub 2018 Dec 20.
6
A revealing forehead cutaneuos lesion: Pott's "puffy" tumor.一个具有提示性的前额皮肤病变:波特氏“肿胀”肿瘤。
Turk Pediatri Ars. 2017 Mar 1;52(1):57. doi: 10.5152/TurkPediatriArs.2016.4928. eCollection 2017 Mar.
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Pott's puffy tumour.
J Paediatr Child Health. 2017 Feb;53(2):197. doi: 10.1111/jpc.1_13275.
8
Midline Craniofacial Masses in Children.儿童中线颅面部肿物
Semin Plast Surg. 2016 Nov;30(4):176-180. doi: 10.1055/s-0036-1593482.
9
Pott's puffy tumor: rare complication of sinusitis.波特氏浮肿性肿瘤:鼻窦炎的罕见并发症。
Braz J Otorhinolaryngol. 2020 Nov-Dec;86(6):812-814. doi: 10.1016/j.bjorl.2016.08.005. Epub 2016 Aug 24.
10
Unusual Cause of Seizure: Pott Puffy Tumor.癫痫发作的罕见病因:波特氏浮肿性肿瘤。
J Craniofac Surg. 2016 Sep;27(6):e548-9. doi: 10.1097/SCS.0000000000002860.

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