Presentation of Pott’s Puffy Tumour in a 71-Year-Old Man with Atypical History

Pott’s puffy tumour is a subperiosteal abscess of the frontal bone with osteomyelitis which has become rare because of the widespread use of antibiotics [1]. It is usually seen as a complication of frontal sinusitis [2]. Here we report a case of Pott’s puffy tumour (PPT) in a 71-year-old man who visited the accident & emergency department with painful swelling of the forehead but with no reported antecedent history of any symptoms of rhinitis or sinusitis. The application of a high index of clinical suspicion ensured that the appropriate clinical assessment was carried out and the presence of asymptomatic rhinosinusitis was established as aetiology for the PPT. The establishment of the aetiology permitted timely intervention with a combined endoscopic and external sinus drainage procedure. The patient was subsequently managed with parenteral IV antibiotics. Employing a high index of suspicion for occult sinus disease as causation for this presentation ensured that this patient received the intervention, avoiding the possibility of complications such as a retrograde intra-cranial extension.