Pott’s Puffy Tumor: A Rare Complication of Frontal Sinusitis
—An ENT Case Report

Background: Pott’s puffy tumor (PPT) is a rare but severe complication of frontal sinusitis, defined by a subperiosteal abscess associated with frontal bone osteomyelitis. Although uncommon in the antibiotic era, it remains a potentially life-threatening condition due to the risk of intracranial extension. Early diagnosis and multidisciplinary management are essential to prevent morbidity. Case Presentation: We report the case of a 22-year-old male presenting with a 5-month history of progressive bilateral frontal headaches, followed by left periorbital and frontal swelling. Clinical examination revealed a tender, erythematous frontal tumefaction without neurological deficit. Laboratory tests showed elevated inflammatory markers (CRP 151 mg/L; leukocytosis 12,000/mm³). Craniofacial computed tomography demonstrated left frontal sinusitis complicated by anterior frontal table erosion, subperiosteal abscess, and frontal osteomyelitis, consistent with PPT, associated with bilateral maxillary sinusitis and preseptal cellulitis. The patient received broad-spectrum intravenous antibiotics (amoxicillin-clavulanate and metronidazole) for 14 days, followed by oral therapy to complete a six-week course. Adjunctive corticosteroid therapy was administered for persistent inflammatory edema. Although initial clinical and biological improvement was achieved, recurrence occurred one month after discharge, necessitating endoscopic frontal sinusotomy (DRAF 2a), with favorable postoperative evolution. Conclusion: PPT remains a rare but serious complication of frontal sinusitis in young adults. Its presentation may be insidious, delaying diagnosis. Early imaging, prolonged antibiotic therapy, and timely surgical intervention when indicated are crucial to prevent recurrence and intracranial complications. Close follow-up is mandatory to ensure complete resolution.