meropenem and Pott-Puffy-Tumor

Topics: Anti-Bacterial Agents; Child; Craniotomy; Drainage; Endoscopy; Epidural Abscess; Female; Fusobacterium Infections; Humans; Magnetic Resonance Imaging; Meropenem; Paranasal Sinuses; Pott Puffy Tumor; Staphylococcal Infections; Thienamycins; Tomography, X-Ray Computed; Vancomycin

A Pott's puffy tumour is a subperiosteal abscess and osteomyelitis of the frontal bone secondary to frontal sinusitis. Intracranial complications are seen in approximately 40 per cent of cases and are potentially life-threatening; such complications have not previously been reported in pregnancy.. A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. Imaging confirmed Pott's puffy tumour with right-sided epidural empyema and periorbital cellulitis. A multidisciplinary team was involved in the patient's management. Intravenous antibiotics were commenced and initial percutaneous drainage through the frontal sinus skin was performed, followed by endoscopic sinus drainage. A caesarean section was performed 3 days later. Complete resolution of the sinus and intracranial collections was noted on imaging performed six weeks later.. This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.

Topics: Anti-Bacterial Agents; Catheterization; Ceftriaxone; Cesarean Section; Drainage; Drug Therapy, Combination; Endoscopy; Female; Frontal Sinusitis; Headache; Humans; Magnetic Resonance Imaging; Meropenem; Orbital Cellulitis; Patient Care Team; Pott Puffy Tumor; Pregnancy; Pregnancy Complications, Infectious; Streptococcal Infections; Thienamycins; Treatment Outcome; Vancomycin; Young Adult