Tumor Inflamatorio de Pott: reporte de un caso y revisión de la literatura / Pott's puffy tumor: a case report and review of the literature

INTRODUCCIÓN: El Tumor inflamatorio de Pott es una complicación rara de una patología frecuente, como son los cuadros infecciosos sinusales, cada vez más inusual por el uso extendido de antibióticos de amplio espectro, es más frecuente en la población adolescente por la neumatización similar al adulto. Se presenta como un aumento de volumen blando a nivel frontal con una osteomielitis del hueso frontal y un absceso subperióstico. MATERIALES Y MÉTODOS: En este trabajo, se presenta una revisión bibliográfica del tema y un caso de un paciente de 9 años, quien cursó con un cuadro infeccioso sinusal, que posterior desarrollo un aumento de volumen frontal, mostrando las imágenes perioperatorias e intraoperatorias. DISCUSIÓN Y CONCLUSIÓN: El absceso subperióstico secundario a la sinusitis, es una complicación rara. Sin embargo, se debe pensar en el diagnostico en pacientes de evolución tórpida y/o que presentan sintomatología neurológica, como convulsiones, se debe completar el estudio con neuroimagen contrastada.

INTRODUCTION: Pott's inflammatory tumor is a rare complication of a frequent pathology, such as sinus infections, increasingly unusual due to the use of broad-spectrum antibiotics, it is more frequent in the adolescent population due to pneumatization similar to that of adults. It presents as an increase in volume at a frontal level with osteomyelitis of the frontal bone and a subperiosteal abscess. ;MATERIAL AND METHODS: In this work, we present a bibliographic review and a case of a 9-year-old patient, who presented with an infectious sinus, which later developed an increase in frontal volume, the perioperative and intraoperative images are shown. DISCUSSION AND CONCLUSION: Subperiosteal abscess secondary to sinusitis is a rare complication. However, the diagnosis should be considered in patients with torpid evolution and / or who present neurological symptoms, such as seizures, the study must be completed with a contrast brain image.

Pott's puffy tumor by Actinomyces after minor head trauma. / Pott's puffy tumor por Actinomyces tras trauma craneal leve.

Pott's puffy tumour (PPT) is a rare entity that involves scalp swelling associated with subperiosteal abscess and cranial osteomyelitis, occasionally accompanied by intracranial infection. It is usually affiliated with frontal sinusitis, which is a typical but infrequent complication. On the contrary, Osteomyelitis by Actinomyces is rare and usually occurs at the mandibular level, with very few cases of cranial osteomyelitis caused by this bacterial specie, especially after traumatic brain injury. We report an exceptionally unusual case of a PPT frontal tumor after blunt trauma (closed head injury), with an intracranial lesion whereby Actinomyces was isolated after surgery, as a co-participant of the mentioned infection besides Fusobacterium and Propionibacterium.

Complicated Fusobacterium Sinusitis: A Case Report.

Fusobacterium infections and Lemierre syndrome are traditionally associated with pharyngitis. We report 3 cases of Fusobacterium sinusitis that resulted in Pott puffy tumor. One of these cases also had Lemierre Syndrome. We encourage expansion of the clinical spectrum of Lemierre syndrome to include complicated Fusobacterium sinusitis.

Cefalea y edema fronto-orbitario de aparición súbita en un adolescente / Fronto-orbital headache and oedema of sudden onset in an adolescent

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Frontal epidural empyema (Pott's puffy tumor) associated with Mycoplasma and depression.

UNLABELLED: A 37-year-old male has left exophthalmia, which gradually evolved in the last two years, finally with a deviation of left eye (LE), down side and out, with gradually decrease of visual acuity (VA). These symptoms are accompanied with headache and psychiatric manifestations with irritability, decreased attention, anxiety, insomnia, depressed mood. Brain Computed Tomography (CT) shows a tumor mass in air leakage sinus, bilateral frontal and bilateral ethmoidal, with left orbital invasion. This tumor mass lysis by pressure the supero-posterior wall of the left orbit, with the delimitation of a frontal epidural process with a capsule and calcifications. Additionally, it has been shown there is a bilateral maxillary sinusitis. The surgical intervention removed the infection focal spots rearranging the left eyeball, recovering the VA. The sinuses were drained. The psychiatric symptoms in the post operatory phase disappeared. Histopathological examination of the excised tissue revealed sinus ciliated respiratory mucosa with mixed acute and chronic inflammatory infiltrate and focal squamous metaplasia. The lamina propria is edematous and contains large numbers of neutrophils, lymphocytes and plasma cells. Histopathological diagnosis is acute and chronic sinusitis. CONCLUSIONS: An untreated infection of the aerial sinuses can lead to a complication like Pott's puffy tumor. When signs such as ophthalmologic, psychiatric and intense headaches appear, it suggests the presence of the Pott's puffy tumor (PPT). The clinical signs are reversible once the tumor has been removed.

The significance of Streptococcus anginosus group in intracranial complications of pediatric rhinosinusitis.

OBJECTIVE: To assess the significance of the Streptococcus anginosus group in intracranial complications of pediatric patients with rhinosinusitis. DESIGN: Retrospective cohort study. SETTING: Tertiary pediatric hospital. PATIENTS: A 20-year review of medical records identified patients with intracranial complications resulting from rhinosinusitis. In the 50 cases identified, S anginosus was the most commonly implicated bacterial pathogen in 14 (28%). Documented data included demographics, cultured bacteria, immune status, sinuses involved, type of intracranial complication, otolaryngologic surgical and neurosurgical intervention, type and duration of antibiotics used, and resulting neurologic deficits. Complications and outcomes of cases of S anginosus group-associated rhinosinusitis were compared with those of other bacteria. MAIN OUTCOME MEASURES: The severity and outcomes of intracranial complications of pediatric rhinosinusitis due to S anginosus group bacteria compared with other bacteria. RESULTS: Infection caused by the S anginosus group resulted in more severe intracranial complications (P = .001). In addition, patients with S anginosus group-associated infections were more likely to require neurosurgical intervention (P < .001) and develop long-term neurologic deficits (P = .02). Intravenous antibiotics were administered for a longer duration (P < .001) for S anginosus group-associated infections. CONCLUSIONS: Rhinosinusitis associated with the S anginosus group should be considered a more serious infection relative to those caused by other pathogens. Streptococcus anginosus group bacteria are significantly more likely than other bacteria to cause more severe intracranial complications and neurologic deficits and to require neurosurgical intervention. A low threshold for intervention should be used for infection caused by this pathogen.

Pott puffy tumor appearing with a frontocutaneous fistula.

Pott puffy tumor is defined as a forehead-localized swelling with overlying subperiosteal abscess and osteomyelitis of the frontal bone. It is an uncommon disease entity and more rarely reported with its frontocutaneous fistula. We report the unusual case of Pott puffy tumor appearing with a frontocutaneous fistula. We performed a frontal sinus surgery using a combined endonasal and percutaneous approach and frontal bone reconstruction with a resorbable mesh plate and bone cement. During a follow-up 1 year after the surgery, there was no recurrence, and we achieved excellent result from the aesthetic point of view.