Pott's puffy tumour and intracranial complications of frontal sinusitis in pregnancy.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.
Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. chloedomvillelewis@gmail.com
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Domville-Lewis
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Friedland
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Santa Maria
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002404:Catheterization; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D002585:Cesarean Section; D004322:Drainage; D004359:Drug Therapy, Combination; D004724:Endoscopy; D005260:Female; D015522:Frontal Sinusitis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D000077731:Meropenem; D054517:Orbital Cellulitis / Q000209:etiology; D010348:Patient Care Team; D059369:Pott Puffy Tumor / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D013845:Thienamycins / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D014640:Vancomycin; D002443:Ceftriaxone; D000077731:Meropenem