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Pott's puffy tumour: harbinger of intracranial sepsis
  1. Yogesh M Bhatt,
  2. Antonio Belloso
  1. Department of Otorhinolaryngology Head and Neck Surgery, Royal Blackburn Hospital, Blackburn, Lancashire, UK
  1. Correspondence to Mr Yogesh M Bhatt, Specialist Registrar in Otolaryngology, Head-Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Royal Blackburn Hospital, Haslingden Road, Blackburn, Lancashire BB2 3HH, UK; bhatt_ym{at}yahoo.co.uk

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A 60-year-old woman presented with a 4-week history of unilateral forehead swelling following a coryzal episode. She described frontomaxillary pain and nasal discharge. Examination confirmed a fluctuant non-tender swelling (figure 1A) and ipsilateral mucopurulent rhinorrhoea. Neuro-ophthalmic examinations were unremarkable. A contrast-enhanced CT scan revealed a right-sided pansinusitis (figure 1B), an external subperiosteal collection with an underlying small extradural collection (figure 1C) and an interposed rarefied frontal bone (figure 1D). She underwent endoscopic sinus drainage with external frontal sinus trephine. The intracranial collection was managed conservatively with intravenous antibiotics and serial CT scans.

Figure 1

(A) Clinical photograph of unilateral forehead swelling. Coronal CT scans demonstrate (B) opacification of the right maxillary and ethmoid sinuses and nasofrontal duct. Axial CT images …

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