Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T15:54:52.008Z Has data issue: false hasContentIssue false
  • English
  • Français

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: [email protected]
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Babu, RP, Todor, R, Kasoff, SS. Pott's puffy tumor: the forgotten entity. Case report. J Neurosurg 1996;84:110–12CrossRefGoogle ScholarPubMed
2Pott, P. Observations on the Nature and Consequences of Wounds and Contusions of the Head. London: C Hitch and L Hawes, 1760Google Scholar
3Bradley, PJ, Manning, KP, Shaw, MD. Brain abscess secondary to paranasal sinusitis. J Laryngol Otol 1984;98:719–25CrossRefGoogle ScholarPubMed
4Dawes, JD. The management of frontal sinusitis and its complications. J Laryngol Otol 1961;75:297–344CrossRefGoogle ScholarPubMed
5Thomas, JN, Nel, JR. Acute spreading osteomyelitis of the skull complicating frontal sinusitis. J Laryngol Otol 1977;91:55–62CrossRefGoogle ScholarPubMed
6Marshall, AH, Jones, NS. Osteomyelitis of the frontal bone secondary to frontal sinusitis. J Laryngol Otol 2000;114:944–6CrossRefGoogle ScholarPubMed
7Kountakis, SE, Senior, B, Draf, W, eds. The Frontal Sinus. Berlin, Heidelberg, New York: Springer, 2005CrossRefGoogle Scholar
8Osborn, MK, Steinberg, JP. Subdural empyema and other suppurative complications of paranasal sinusitis. Lancet Infect Dis 2007;7:62–7CrossRefGoogle ScholarPubMed
9Younis, RT, Lazar, RH, Anand, VK. Intracranial complications of sinusitis: a 15-year review of 39 cases. Ear Nose Throat J 2002;81:636–8, 640–2, 644CrossRefGoogle ScholarPubMed
10Jones, NS, Walker, JL, Bassi, S, Jones, T, Punt, J. The intracranial complications of rhinosinusitis: can they be prevented? Laryngoscope 2002;112:59–63CrossRefGoogle ScholarPubMed
11Gallagher, RM, Gross, CW, Phillips, CD. Suppurative intracranial complications of sinusitis. Laryngoscope 1998;108:1635–42CrossRefGoogle ScholarPubMed
12Wax, JR, Blackstone, J, Mancall, A, Cartin, A, Pinette, MG. Sinogenic brain abscess complicating pregnancy. Am J Obstet Gynecol 2004;191:1711–12CrossRefGoogle ScholarPubMed
13Kim, HC, Kang, SG, Huh, PW, Yoo do, S, Cho, KS, Kim, DS. Pituitary abscess in a pregnant woman. J Clin Neurosci 2007;14:1135–9CrossRefGoogle ScholarPubMed
14Connealy, BD, Lovgren, TR, Tomich, PG, Smith, CV, Berg, TG. Spontaneous methicillin-resistant Staphylococcus aureus epidural abscess in pregnancy. Obstet Gynecol 2010;116:498–501CrossRefGoogle ScholarPubMed
15Hunter, JC, Ryan, MD, Taylor, TK, Pennington, JC. Spinal epidural abscess in pregnancy. Aust N Z J Surg 1977;47:672–4CrossRefGoogle ScholarPubMed
16Lampen, R, Bearman, G. Epidural abscess caused by Streptococcus milleri in a pregnant woman. BMC Infect Dis 2005;5:100CrossRefGoogle ScholarPubMed
17Van Winter, JT, Nielsen, SN, Ogburn, PL Jr.Epidural abscess associated with intravenous drug abuse in a pregnant patient. Mayo Clin Proc 1991;66:1036–9CrossRefGoogle ScholarPubMed
18Clayman, GL, Adams, GL, Paugh, DR, Koopmann, CF Jr.Intracranial complications of paranasal sinusitis: a combined institutional review. Laryngoscope 1991;101:234–9CrossRefGoogle ScholarPubMed
19Singh, B, Van Dellen, J, Ramjettan, S, Maharaj, TJ. Sinogenic intracranial complications. J Laryngol Otol 1995;109:945–50CrossRefGoogle ScholarPubMed
20Small, M, Dale, BA. Intracranial suppuration 1968–1982 – a 15 year review. Clin Otolaryngol Allied Sci 1984;9:315–21CrossRefGoogle Scholar
21Maniglia, AJ, Goodwin, WJ, Arnold, JE, Ganz, E. Intracranial abscesses secondary to nasal, sinus, and orbital infections in adults and children. Arch Otolaryngol Head Neck Surg 1989;115:1424–9CrossRefGoogle ScholarPubMed
22Ellegard, E, Hellgren, M, Toren, K, Karlsson, G. The incidence of pregnancy rhinitis. Gynecol Obstet Invest 2000;49:98–101CrossRefGoogle ScholarPubMed
23Ellegard, EK. Pregnancy rhinitis. Immunol Allergy Clin North Am 2006;26:119–35CrossRefGoogle ScholarPubMed
24Giannoni, CM, Stewart, MG, Alford, EL. Intracranial complications of sinusitis. Laryngoscope 1997;107:863–7CrossRefGoogle ScholarPubMed
25Fenton, JE, Smyth, DA, Viani, LG, Walsh, MA. Sinogenic brain abscess. Am J Rhinol 1999;13:299–302CrossRefGoogle ScholarPubMed
26DelGaudio, JM, Evans, SH, Sobol, SE, Parikh, SL. Intracranial complications of sinusitis: what is the role of endoscopic sinus surgery in the acute setting. Am J Otolaryngol 2010;31:25–8CrossRefGoogle ScholarPubMed
27Jacob, CE, Kurien, M, Varghese, AM, Aleyamma, TK, Jasper, P, Prabu, K et al. Treatment of otogenic brain abscess in pregnancy. Otol Neurotol 2009;30:602–3CrossRefGoogle ScholarPubMed
28Braun, TI, Kerson, LA, Eisenberg, FP. Nocardial brain abscesses in a pregnant woman. Rev Infect Dis 1991;13:630–2CrossRefGoogle ScholarPubMed