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

Published online by Cambridge University Press:  15 August 2012

C Domville-Lewis ,
P L Friedland  and
P L Santa Maria
C Domville-Lewis*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Department of Ear Sciences, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia Ear Sciences Institute Australia, Perth, Western Australia, Australia
P L Friedland
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Department of Ear Sciences, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia Ear Sciences Institute Australia, Perth, Western Australia, Australia
P L Santa Maria
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Department of Ear Sciences, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia Ear Sciences Institute Australia, Perth, Western Australia, Australia
*
Address for correspondence: Dr Chloe Domville-Lewis, c/o Department of Otolaryngology, Head and Neck Surgery, 1st Floor, E Block Outpatients, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands WA, Australia 6009 Fax: +61 8 9346 4899 E-mail: chloedomvillelewis@gmail.com
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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.

Keywords

Frontal SinusitisPott's Puffy TumorPregnancySinusitisIntracranial Abscess
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S1 , January 2013 , pp. S35 - S38
Copyright
Copyright © JLO (1984) Limited 2012

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