Pott puffy tumor in a 4-year-old boy presenting in status epilepticus

Pott puffy tumor is an osteomyelitis of the frontal bone with the development of a subperiosteal abscess manifesting as a puffy swelling of the forehead or scalp. It is believed to occur as a complication of frontal sinusitis. The modern antibiotic era has made it a rarely encountered entity. This case describes a 4-year-old boy who presented in status epilepticus secondary to Pott puffy tumor.     

Pott's puffy tumor: a rare complication of mastoiditis

Pott's puffy tumor is rarely seen in the modern era of antibiotics. It is usually seen as intracranial complication following inappropriately treated frontal sinusitis. Up until 2001 there have been only 21 pediatric cases reported in the literature and most have been secondary to frontal sinusitis. Only 1 case has been reported following a latent mastoiditis and that has been in an adult [1]. We report a case in a child who developed Pott's puffy tumor following mastoiditis.     

Pott's puffy tumor: a complication of frontal sinusitis

In children sinusitis is a frequent complication of upper respiratory infections but an infrequently considered diagnosis. Although most sinus infections are resolved without complications, when complications do occur they can be serious or life threatening. The most common ones occur in the orbit, but CNS extension is not infrequent. Osteomyelitis and resulting subperiosteal abscess of the frontal bone--the so-called Pott's puffy tumor--is a less common, and perhaps less frequently recognized, serious complication of frontal sinusitis. This paper describes two patients with subperiosteal abscess resulting from frontal sinusitis, one with CNS and orbital extension. A brief literature review is presented, and presentation, diagnosis, and treatment are discussed.     

A rare clinical entity: Pott's puffy tumor. A case report

Pott's puffy tumor is a rare clinical entity described as osteomyelitis of the frontal bone associated with subperiosteal abscess. The causative factors and treatment modalities are discussed in light of the literature.     

Intracranial complications of frontal sinusitis in children: Pott's puffy tumor revisited

The objective of the present study is to describe the diagnosis and treatment of intracranial complications of frontal sinusitis (Pott's puffy tumor) in a series of pediatric patients at our institution. A rare entity, Pott's puffy tumor has been reported in only 21 pediatric cases in the literature of the antibiotic era. The hospital records and radiographic files at Rainbow Babies and Childrens Hospital, Cleveland, Ohio, USA, over the previous 16 years were retrospectively reviewed in a search for patients with the diagnosis of Pott's puffy tumor, defined as scalp swelling and associated intracranial infection. There were 6 male patients and 1 female patient. Ages ranged from 11 to 18 years (median 14.5 years). Intracranial infections consisted of epidural abscess in 5 patients, subdural empyema in 4 and brain abscess in 1. Intraoperative cultures grew anaerobic organisms in 1 patient, microaerophilic streptococcus in 5 patients, Klebsiella species in 1 patient and Streptococcus pneumoniae in another. All patients presented with frontal scalp swelling, and other common symptoms included headache, fever, nasal drainage and frontal sinus tenderness. Five patients were treated with antibiotics prior to their presentation. Four patients presented with neurologic decompensation characterized by varying degrees of hemiparesis, obtundation, pupillary dilatation or aphasia. All patients underwent craniotomy and evacuation of the intracranial infection. Even severely impaired patients demonstrated full neurologic recovery. Despite the widespread use of antibiotics, neurosurgical complications of sinusitis continue to occur. A high degree of suspicion, along with prompt neurosurgical intervention and the use of appropriate antibiotics, can result in favorable outcomes in even the sickest patients.     

Pott's puffy tumor in a 12‐year‐old boy

Pott's puffy tumor (PPT) is a rare complication of sinusitis characterized by subperiosteal abscess and osteomyelitis of the frontal bone. Early diagnosis and treatment is vital before it causes intracranial complications such as subdural empyema or brain abscess. Herein we describe the case of a 12‐year‐old patient who developed preseptal cellulitis and PPT, and was successfully treated with abscess drainage, sinus surgery and long‐term antibiotic therapy.     

Radiolabelled leucocytes: a new diagnostic tool in occult infection/inflammation.

Autologous white blood cells were labelled with Indium 111 (111In wbc) and reinjected into 18 children with suspected infection and 10 children with suspected inflammatory bowel disease aged 5 weeks to 15 years. In addition two immunosuppressed children with suspected infection received donor 111In wbc. Gamma camera images were obtained between one and four hours and 20 and 24 hours. Other appropriate investigations were also undertaken in these children. Of 18 positive 111In wbc scans 17 were true positive. There were 12 negative scans of which 9 were true negative and three were false negative. The overall results showed a sensitivity of 85%, a specificity of 90%, and an accuracy of 86%. Used appropriately this technique forms a valuable back up investigation.     

sTREM-1在诊断新生儿细菌感染性疾病中的作用

髓样细胞触发受体(triggering receptors expressed on myeloid cells,TREM)是新近发现的受体家族,其中TREM-1与炎症反应有关,而其可溶性形式sTREM-1与多种炎症疾病密切相关.在新生儿细菌感染性疾病中sTREM-1也呈高表达,有望成为诊断新生儿细菌感染的新指标.     

A teenage girl with a sternal mass: an unusual presentation of Pott disease

Bone and joint infection complicating tuberculosis is most likely to involve vertebrae. Pott disease, or tuberculous spondylitis, represents a small proportion of tuberculosis cases, but it can be associated with significant morbidity and mortality. Our case report details Pott disease in a teenage girl, which presented with a sternal mass. We also present a review of the subject.     

Muscle tumor in a girl with HIV infection: extranodal non-Hodgkin's lymphoma

Non-Hodgkin's lymphomas are the most common cancers in children with human immunodeficiency virus (HIV) infection. Extranodal disease is the most common form of clinical presentation. Treatment with aggressive chemotherapy and highly active antiretroviral therapy has improved the prognosis of these children. We present a 10-year-old severely immunocompromised girl with HIV infection and non-Hodgkin's lymphoma manifested by a muscle mass.     

Prevention of serious bacterial infection in children with nephrotic syndrome

Although nephrotic syndrome is well known as a predisposing factor to bacterial infection in children, especially peritonitis due to Streptococcus pneumoniae , data on the incidence of infection and the effectiveness of preventative measures are limited. With particular reference to pneumococcal disease, this review summarises the available data on the pattern and incidence of invasive bacterial infection in children with nephrotic syndrome, and the level of evidence for the use of penicillin chemoprophylaxis and pneumococcal immunisation. Although data on the effectiveness of pneumococcal immunisation in children with nephrotic syndrome are limited, the safety profile of this vaccine makes the risk–benefit ratio favourable to use of the current polysaccharide vaccine in those over 2 years of age. Conjugate pneumococcal vaccines are likely to be more effective, particularly in children under 2 years of age and should be available by the year 2000. Although penicillin prophylaxis against pneumococcal infection is not of proven benefit for nephrotic syndrome, it is beneficial in sickle cell disease without appreciable risk. Subgroups of patients with nephrotic sydrome most likely to benefit from twice daily phenoxymethyl penicillin prophylaxis include children under 2 years of age, with unresponsive or frequently relapsing disease, or who have had a previous episode of pneumococcal infection.