Clinical communication: Adult| Volume 41, ISSUE 6, P616-622, December 2011

Pott's Puffy Tumor and Epidural Abscess Arising from Pansinusitis

Published:November 21, 2008DOI:



      Sinusitis is a common disorder that can result in rare but serious complications including periorbital or orbital cellulitis, intracranial abscess or meningitis, subperiosteal scalp abscess (“Pott's puffy tumor”), osteomyelitis, and cavernous sinus thrombosis.

      Case Report

      We report a case of a 41-year-old man who presented to our Emergency Department with pansinusitis. He did not obtain recommended follow-up treatment after discharge and 26 days later returned with a persistence of sinusitis, Pott's puffy tumor, and an intracranial abscess caused by Streptococcus intermedius. The patient required multiple otolaryngological and neurosurgical interventions and was treated with long-term antibiotic therapy.


      Pott's puffy tumor is a complicated infection that requires intravenous antibiotic and surgical treatment. Diagnosis is made by contrast-enhanced computed tomography scan. Early treatment significantly contributes to favorable outcome and decreases the risk of further complications such as epidural abscess.


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        • Jackson L.L.
        • Kountakis S.E.
        Classification and management of rhinosinusitis and its complications.
        Otolaryngol Clin North Am. 2005; 38: 1143-1153
        • Devaiah A.K.
        Adult chronic rhinosinusitis: diagnosis and dilemmas.
        Otolaryngol Clin North Am. 2004; 37: 243-252
        • Kasper D.L.
        • Fauci A.S.
        • Longo D.L.
        • et al.
        Harrison's principles of internal medicine.
        McGraw-Hill, New York2005
        • Brook I.
        The role of bacteria in chronic rhinosinusitis.
        Otolaryngol Clin North Am. 2005; 38: 1171-1192
        • Snow V.
        • Mottur-Pilson C.
        • Hickner J.M.
        Principles of appropriate antibiotic use for acute sinusitis in adults.
        Ann Intern Med. 2001; 134: 495-497
        • King D.
        Intracranial complications of sinusitis in a 12-year-old boy.
        Emerg Off Pediatr. 1995; 8: 112-115
        • National Guideline Clearinghouse (NGC)
        Guideline summary.
        (Accessed May 25, 2007)
        • Bambakidis N.C.
        • Cohen A.R.
        Intracranial complications of frontal sinusitis in children: Pott's puffy tumor revisited.
        Pediatr Neurosurg. 2001; 35: 82-89
        • Brook I.
        Microbiology and antimicrobial management of sinusitis.
        Otolaryngol Clin North Am. 2004; 37: 253-266
        • Lund V.J.
        Maximal medical therapy for chronic rhinosinusitis.
        Otolaryngol Clin North Am. 2005; 38: 1301-1310
        • Williamson I.G.
        • Rumsby K.
        • Benge S.
        • et al.
        Antibiotics and topic nasal steroid for treatment of acute maxillary sinusitis.
        JAMA. 2007; 298: 2487-2496
        • National Guideline Clearinghouse (NGC)
        Guideline summary.
        (Accessed May 25, 2007)
        • Metson R.
        • Sindwani R.
        Endoscopic surgery for frontal sinusitis-a graduated approach.
        Otolaryngol Clin North Am. 2004; 37: 411-422
        • Piccirillo J.F.
        Acute bacterial sinusitis.
        N Engl J Med. 2004; 351: 902-910
        • Blackshaw G.
        • Thomson N.
        Pott's puffy tumour reviewed.
        J Laryngol Otol. 1990; 104: 574-577
        • Babu R.P.
        • Todor R.
        • Kasoff S.S.
        Pott's puffy tumor: the forgotten entity.
        J Neurosurg. 1996; 84: 110-112
        • Goldberg A.N.
        • Oroszlan G.
        • Anderson T.D.
        Complications of frontal sinusitis and their management.
        Otolaryngol Clin North Am. 2001; 34: 211-225
        • Clayman G.L.
        • Adams G.L.
        • Paugh D.R.
        • Koopmann C.F.
        Intracranial complications of paranasal sinusitis: a combined institutional review.
        Laryngoscope. 1991; 101: 234-239
        • Chandy B.
        • Todd J.
        • Stucker F.J.
        • Nathan C.O.
        Pott's puffy tumor and epidural abscess arising from dental sepsis: a case report.
        Laryngoscope. 2001; 111: 1732-1734
        • Gallagher R.M.
        • Gross C.W.
        • Phillips C.D.
        Suppurative intracranial complications of sinusitis.
        Laryngoscope. 1998; 108: 1635-1642