Complicated Fusobacterium Sinusitis: A Case Report

Objectives: Pott's puffy tumor (PTT) is a frontal subperiosteal abscess associated with underlying frontal osteomyelitis. The purpose of the present study was to assess the rate of intracranial involvement in pediatric and adolescent patients with PPT and to discuss the diagnostic workup and the therapeutic features of this pathology.Methods: We searched Web of Science, PubMed and MEDLINE from 1998 to 2018. The search focused on papers concerning the diagnostic procedure and therapeutic management of PTT. Statistical techniques were not used.Results: We included 53 articles that described 92 pediatric and adolescent patients with PPT. The overall rate of intracranial complications was found to be 72%. Most authors used computed tomography for the diagnosis of PTT and its complications, either alone or in combination with magnetic resonance imaging. In 50% of cases, an endoscopic endonasal approach is used for the management of the underlying acute or chronic sinusitis.Conclusions: On the basis of the available literature, it seems that the incidence rate of intracranial involvement in patients with PPT is quite high. Early diagnosis using the appropriate imaging raise the possibility of good recovery. Concerning the therapy of PTT, endoscopic sinus surgery could be considered as a valuable technique. The vast majority of patients treated appropriately recover without long-term neurologic complications and sequelae.

show abstract

“…Most of the articles were either case series or case reports. The characteristics of the included studies are summarized in Table …”

Section: Resultsmentioning

confidence: 99%

Pott's puffy tumor in children: A review of the literature

2018

View full text Add to dashboard Cite

show abstract

“…3 But adults can be affected by the PTT, although rare, according to the world English-language literature, only 30-40 cases of adult patients with PPT were reported between 1990 and 2016. 8 The bacterial agents most often involved with PPT are Streptococci (Streptococcus milleri, Streptococcus viridians, Streptococcus pyogenes e Streptococcus pneumoniae), Staphylococcus aureus, and some anaerobic bacteria (Bacteroides and Fusobacterium 14,20,26,33 , Mycoplasma 27 , Klebisiella pneumoniae 28 and Pseuodomonas aeruginosa 30 ). These agents are the most common ones found in acute bacterial rhinosinusitis; an important fact is that most infections are caused by more than one etiologic agent.…”

Section: Discussionmentioning

confidence: 99%

Pott’s Puffy Tumor - Overview of case series

Severo

Medeiros²,

Gadelha³

et al. 2021

jmm

View full text Add to dashboard Cite

Pott’s puffy tumor (PPT) is rare and usually seen as a complication of frontal sinusitis that has been neglected or partially treated, resulting in subperiosteal abscess of the frontal bone with underlying osteomyelitis, which can lead to life-threatening intracranial complications, such as epidural/subdural empyema, cerebral abscess and meningitis. Given this, the purpose of the present study was to gather the most diverse cases reported together to highlight the main treatment methods. Methods: It is a narrative review, starting from the search in the database PubMed, Lilacs and Scielo from 2010 to 2020, which resulted in 34 scientific articles. The search focused on obtaining data on new approaches and treatments established for Pott’s puffy tumor. Results: 34 articles were included which described 58 patients with a swollen Pott tumor, occurring predominantly in male adolescents, with streptococci (26,1%) as the main etiologic agent. Approximately 84% of all patients were male subjects. The most prevalent intracranial complication was an epidural or extradural abscess (84,2%). Regarding PTT therapy, all patients received antibiotic therapy (ATB), and the main empirical antimicrobial scheme used was cephalosporin third generation, with vancomycin and metronidazole. In most cases, surgery was performed using several techniques, mainly an external surgical approach, external drainage (ED) of the subperiosteal abscess associated with endoscopic sinus surgery (ESS). In general, the prognosis is favorable, even if neurological symptoms are present at admission. Conclusion: Based on available literature, PPT is a profoundly serious complication, which can be easily avoided if treated with the ATB, ED and ESS triad immediately, and, if necessary, craniotomy.

show abstract

“…3 Although F. necrophorum is implicated in oropharyngeal infection, sinusitis caused by this organism is unusual and progression from sinusitis to Lemierre's syndrome is rare. 6 It is important to consider F. necrophorum as a potential causative organism for head and neck infections regardless of the primary site and consider this possibility when selecting empiric antimicrobials in unwell patients.…”

Section: Discussionmentioning

confidence: 99%

Atypical Lemierre's syndrome complicated by transcalvarial brain herniation

Wang

Burgner

Chen

2021

J Paediatrics Child Health

View full text Add to dashboard Cite

Lemierre's syndrome was first described by French bacteriologist Andre-Alfred Lemierre in 1936 and includes oropharyngeal infection with progression to sepsis, internal jugular vein thrombosis and disseminated septic emboli, usually caused by Fusobacterium necrophorum and occasionally by other bacteria, including Staphylococcus aureus. 1 Lemierre's syndrome is rare, although the incidence may be increasing due to more judicious antibiotic prescribing for oropharyngeal infections. 2 It is less common in younger children and therefore the diagnosis may not be considered until complications arise. 2 We describe an atypical case of Lemierre's syndrome culminating in septic thromboembolic disease.

show abstract

Complicated Fusobacterium Sinusitis: A Case Report

Cited by 15 publications

References 9 publications

Pott's puffy tumor in children: A review of the literature

Pott's puffy tumor in children: A review of the literature

Pott’s Puffy Tumor - Overview of case series

Atypical Lemierre's syndrome complicated by transcalvarial brain herniation

Contact Info

Product

Resources

About