Headache of a diagnosis: frontotemporal pain and inflammation associated with osteolysis.
A 62-year-old woman presented with left frontotemporal pain, scalp tenderness and raised levels of inflammatory markers. Temporal arteritis was considered likely, and symptoms resolved with prednisone therapy. This delayed diagnostic bone biopsy until a soft tissue abscess formed, and Pott's puffy tumour associated with Prevotella osteomyelitis of the frontal bone was diagnosed. This case highlights the value of early histopathological examination, and is a reminder of a condition seen frequently in the pre-antibiotic era.
Tacon
Lyndal J
LJ
Royal North Shore Hospital, Sydney, NSW, Australia. ltacon@med.usyd.edu.au
Parkinson
Jonathon F
JF
Hudson
Bernard J
BJ
Brewer
Janice M
JM
Little
Nicholas S
NS
Clifton-Bligh
Roderick J
RJ
D016866:Bacteroidaceae Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005624:Frontal Bone; D006261:Headache / Q000209:etiology / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010014:Osteolysis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D001443:Prevotella melaninogenica