title: Frontal epidural empyema (Pott's puffy tumor) associated with Mycoplasma and depression.
abstract: A 37-year-old male has left exophthalmia, which gradually evolved in the last two years, finally with a deviation of left eye (LE), down side and out, with gradually decrease of visual acuity (VA). These symptoms are accompanied with headache and psychiatric manifestations with irritability, decreased attention, anxiety, insomnia, depressed mood. Brain Computed Tomography (CT) shows a tumor mass in air leakage sinus, bilateral frontal and bilateral ethmoidal, with left orbital invasion. This tumor mass lysis by pressure the supero-posterior wall of the left orbit, with the delimitation of a frontal epidural process with a capsule and calcifications. Additionally, it has been shown there is a bilateral maxillary sinusitis. The surgical intervention removed the infection focal spots rearranging the left eyeball, recovering the VA. The sinuses were drained. The psychiatric symptoms in the post operatory phase disappeared. Histopathological examination of the excised tissue revealed sinus ciliated respiratory mucosa with mixed acute and chronic inflammatory infiltrate and focal squamous metaplasia. The lamina propria is edematous and contains large numbers of neutrophils, lymphocytes and plasma cells. Histopathological diagnosis is acute and chronic sinusitis.
  
  
  CONCLUSIONS
  An untreated infection of the aerial sinuses can lead to a complication like Pott's puffy tumor. When signs such as ophthalmologic, psychiatric and intense headaches appear, it suggests the presence of the Pott's puffy tumor (PPT). The clinical signs are reversible once the tumor has been removed.
authors.affiliation: Department of Psychiatry, "Carol Davila" University of Medicine and Pharmacy; 1st Department, "Prof. Dr. Alexandru Obregia" Clinical Psychiatry Hospital, Bucharest, Romania; adela.ciobanu@gmail.com.
authors.forename: Adela Magdalena
authors.initials: AM
authors.lastname: Ciobanu
authors.forename: Tatiana
authors.initials: T
authors.lastname: Roşca
authors.forename: Camelia Teodora
authors.initials: CT
authors.lastname: Vlădescu
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tihoan
authors.forename: Mihaela Camelia
authors.initials: MC
authors.lastname: Popa
authors.forename: Monica Claudia
authors.initials: MC
authors.lastname: Boer
authors.forename: Romică
authors.initials: R
authors.lastname: Cergan
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications*; D004653:Empyema / Q000150:complications* / Q000382:microbiology*; D005094:Exophthalmos / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009174:Mycoplasma / Q000502:physiology*; D059369:Pott Puffy Tumor / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed