Pott's Puffy Tumor Arising From Pansinusitis - A Mimicker of Preseptal Cellulitis | IOVS | ARVO Journals

Purpose : We describe two cases of Pott's puffy tumor as a complication arising from pansinusitis, with an initial presentation to Ophthalmology department as a mimicker of preseptal cellulitis.

Methods : Case reports.

Results : We report two cases of Pott's puffy tumor with underlying pansinusitis which presented to our Ophthalmology department between September 2011 and February 2012 with the initial diagnosis of preseptal cellulitis, and subsequently co-managed with the Ear Nose Throat (ENT) team. The first case was a 43-year-old male who presented with a three-weeks' history of left-sided nasal obstruction and frontal swelling, associated with headache and central blurring of vision. A Computed Tomography (CT) scan of the orbits and sinuses showed pansinusitis with a left frontal bone abscess with osteomyelitis and an extradural empyema. The second case was a 58-year-old male with a history of sinusitis, who presented with a 2-weeks' history of frontal and periorbital swelling following a fall. CT imaging showed pansinusitis with a frontal frontal mucopyocele, and bony erosion of frontal sinus and bone, suggestive of underlying chronic osteomyelitis. Both patients were co-managed with ENT and treated with intravenous antibiotics, endoscopic sinus surgery and incision and drainage of the abscess. Pott's puffy tumor can present as a complication of pansinusitis with frontal swelling, mimicking preseptal cellulitis. These two cases demonstrate the importance of early imaging of the orbits and sinuses, and the appropriate co-management with ENT for surgical intervention to prevent a delay in diagnosis and progression to life-threatening intracranial complications.