Evaluation of adult pott's puffy tumor: Our five cases and 27 literature cases

Abstract

Although the incidence rate of major complications is lower than in children and later than in earlier published adult cases, patients are still at high risk of serious intracranial complications. Early diagnosis and adequate treatment may contribute to reducing the incidence rate.

A 14-Year-Old Male with Swelling of the Forehead

“…10 Adult cases of varied range of age have also been reported. 11 In addition to swelling on the forehead, other common symptoms include headache, fever, nasal discharge, periorbital edema, and fatigue. 3,4 More serious presentations such as lethargy, seizures, obtundation, nausea, and vomiting are indicative of possible intracranial spread.…”

Pott’s Puffy Tumor: A New Complication of HIV

“…The head trauma 13 years prior to our patient presentation resulted in displaced fractures of the frontal table of the frontal sinus and the naso-orbital-ethmoid complex, both were surgically repaired. The resultant traumaticallyaltered cranial anatomy is one identified cause for PPT, but with a thirteen-year gap, making the case one with the longest trauma-PPT latency period reported to date [5]. Additionally, the frontal sinus drainage pathway became dysfunctional due to the aforementioned anatomic changes.…”

“…The true causes and mechanism of developing PPT are still unclear. Fortunately, proper treatment with antibiotics/surgery is helpful in the majority of cases [5]. Left untreated, PPT may lead to complications that include -but are not limited to: meningitis, dural empyema, dural vein thrombosis, and brain abscess [3].…”

“…It is also observed much more commonly in adolescents [4]. To our knowledge, only 32 prior cases of adult PPT have been reported [5]. Perhaps two of the most severe complications are subdural empyema and brain abscess.…”

“…The infectious etiology varies from case to case, but the most common organisms are streptococci, staphylococci, and anaerobes [3,9]. Examination of the published cases shows that most patients required surgical drainage in addition to antibiotic therapy [5].…”