Silent danger behind the forehead: Pott's puffy tumour presenting without systemic symptoms.

Pott's puffy tumour (PPT) is a rare complication of frontal sinusitis involving subperiosteal abscess and frontal bone osteomyelitis, often leading to serious intracranial sequelae. We report a case of a man in his 50s who presented with progressive, painless forehead swelling despite multiple antibiotic courses. Imaging confirmed bilateral subperiosteal collections and a right-sided epidural empyema. Initial management included broad-spectrum antibiotics, endoscopic sinus surgery and external drainage. Due to persistent collections, a second-stage osteoplastic approach was performed, resulting in complete resolution. Cultures were sterile, possibly due to early antibiotic administration. The patient completed 6 weeks of parenteral antibiotics and remained symptom-free at the 8-month follow-up. This case highlights the importance of early recognition, imaging and surgical management of PPT to prevent complications. An individualised, combined endoscopic and external approach may be essential in advanced presentations.
Chronic respiratory disease
Care/Management

Authors

Rodrigues Rodrigues, Duarte Duarte, Oliveira Oliveira
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