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一例罕见病例报告:一名成年男性患波特氏头皮脓肿、勒米尔氏综合征并伴有颅内并发症。

A rare case report: Pott's Puffy tumor and Lemierre's syndrome with intracranial complications in an adult male.

作者信息

Azouz Ines, Moussaoui Marwa, Dahech Dhia, Jdidi Rihab, Aissa Amene

机构信息

Department of Radiology, Ibn Jazzar Regional Hospital (Kairouan), Faculty of Medicine of Sousse, Tunisia.

Department of Neurosurgery, Ibn Jazzar Regional Hospital (Kairouan), Faculty of Medecine of Sousse, Tunisia.

出版信息

Radiol Case Rep. 2024 Nov 15;20(1):851-855. doi: 10.1016/j.radcr.2024.10.128. eCollection 2025 Jan.

DOI:10.1016/j.radcr.2024.10.128
PMID:39635425
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11614784/
Abstract

Pott Puffy Tumor (PPT) is extremely rare, yet potentially severe condition characterized by osteomyelitis of the frontal bone associated with one or multiple subperiosteal abscesses, primarily from nasosinusitis. It is characterized by localized frontal swelling accompanied by a subperiosteal abscess. Clinicians and radiologists do not widely recognize this complication of frontal sinusitis and, hence it is likely to be overlooked in clinical practice. We describe, through this article, a unique case of frontal osteomyelitis in an immunocompromised patient, complicated by a subperiosteal orbital abscess, subdural empyema, intracerebral abscesses, superior sagittal sinus thrombosis, and pulmonary septic emboli, which also resulted in septic pulmonary infarcts, aligning with Lemierre's syndrome. Treatment included a combination of antibiotics and surgery, with careful monitoring for orbital and intracranial complications.

摘要

波特氏浮肿性肿瘤(PPT)极为罕见,但却是一种潜在的严重病症,其特征为额骨骨髓炎伴有一个或多个骨膜下脓肿,主要由鼻窦炎引起。其特点是局限性额部肿胀并伴有骨膜下脓肿。临床医生和放射科医生对额窦炎的这种并发症认识并不广泛,因此在临床实践中很可能被忽视。我们通过本文描述了一例免疫功能低下患者发生的独特额骨骨髓炎病例,该病例并发骨膜下眶脓肿、硬膜下积脓、脑脓肿、上矢状窦血栓形成和肺脓毒性栓子,后者还导致了脓毒性肺梗死,符合勒米尔综合征。治疗包括抗生素和手术联合应用,并密切监测眼眶和颅内并发症。

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本文引用的文献

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Management of a Pott puffy tumor: Case report and literature review.波特氏浮肿性肿瘤的治疗:病例报告及文献综述
Int J Surg Case Rep. 2024 Oct;123:110241. doi: 10.1016/j.ijscr.2024.110241. Epub 2024 Sep 5.
2
Pott's Puffy Tumor: A Case Report on Diagnosis Through Imaging.波特氏头皮下脓肿:一例通过影像学诊断的病例报告
Cureus. 2024 Apr 20;16(4):e58640. doi: 10.7759/cureus.58640. eCollection 2024 Apr.
3
Pott's puffy tumor of the upper eyelid misdiagnosed as simple abscess: a case report and literature review.误诊为单纯脓肿的上睑波特氏浮肿性肿瘤:一例报告及文献复习
Arch Craniofac Surg. 2024 Jun;25(3):141-144. doi: 10.7181/acfs.2023.00465. Epub 2024 Mar 6.
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Lemierre's Syndrome in the 21st Century: A Literature Review.21世纪的勒米尔综合征:文献综述
Cureus. 2023 Aug 18;15(8):e43685. doi: 10.7759/cureus.43685. eCollection 2023 Aug.
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A Systematic Review of Intracranial Complications in Adults with Pott Puffy Tumor over Four Decades.四十年来成人波特氏浮肿性肿瘤颅内并发症的系统评价
Brain Sci. 2023 Mar 30;13(4):587. doi: 10.3390/brainsci13040587.
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Pott's puffy tumor: A comprehensive review of the literature.波特氏脓肿:文献综述。
Am J Otolaryngol. 2022 Sep-Oct;43(5):103529. doi: 10.1016/j.amjoto.2022.103529. Epub 2022 Jun 9.
7
Draf III frontal sinus surgery for the treatment of Pott's puffy tumour in adults: our case series and a review of frontal sinus anatomy risk factors.成人波特氏膨出肿的 III 型额窦手术治疗:我们的病例系列及对额窦解剖风险因素的回顾。
Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2271-2278. doi: 10.1007/s00405-020-05980-2. Epub 2020 Apr 29.
8
Pott's Puffy Tumor: A Case Report.波特氏头皮脓炎:病例报告
J Pediatr Health Care. 2019 Sep-Oct;33(5):585-588. doi: 10.1016/j.pedhc.2019.05.005. Epub 2019 Jun 26.
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Hamostaseologie. 2019 Feb;39(1):76-86. doi: 10.1055/s-0038-1654720. Epub 2018 Aug 2.
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Evaluation of adult Pott's puffy tumor: our five cases and 27 literature cases.成人波特氏脓肿的评估:我们的 5 个病例和 27 篇文献病例。
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