Pediatria pre prax 4/2016

An extraordinary case of complication of frontal rhinosinusitis in 17-year old patient – case report

Introduction:Rhinosinusitis is one of the most common diseases in children. In most cases, it is uncomplicated. Complications occur in approximately 2% of cases that require surgical treatment. A special case is Pott‘s puffy tumor – osteomyelitis of frontal bone as a result of frontal purulent rhinosinusitis. Case report:The authors report the case of a 17-year-old boy with Pott‘s puffy tumor following wrong diagnosis and treatment of rhinosinusitis. Discussion:It can be responsible for life-threatening complications, as the first symptoms that appear may be minor. Early diagnosis and appropriate management to prevent orbital and central nervous system complications significantly reduce the morbidity and mortality. CT scan is the examination of choice to confirm the diagnosis. In case of suspicion of intracranial complications, it is essential to perform magnetic resonance of brain. The treatment of Pott‘s puffy tumor is based on surgical drainage of the abscess from external approach supplemented by endoscopic sinus surgery, debridment of necrotic material and antibiotic therapy. Conclusion:Although rare since the advent of broad – spectrum antibiotics, case of Pott‘s puffy tumor can still be observed. It is rare, but serious diagnosis. We have to think of it in cases of appearance of swelling in the frontal area of the patient in order to prevent severe intracranial complications that may threaten patient‘s life.

Keywords: Pott‘s puffy tumor, frontal rhinosinusitis, intracranial complication, osteomyelitis