March 29, 2024

Recently seen in my ED:

An elderly patient is brought in by relatives.  "We’re concerned about the forehead swelling".  Patient has a remote history of a head injury, is pleasant and cooperative.  No diabetes, otherwise pretty healthy.  ROS noncontributory.
forehead unknown

Patent had been seen by a physician the day prior, and a workup had been scheduled for the following weekday. But as this was Friday night, and concern was mounting*, though not symptoms.

Exam: Afeb, normal VS.  Otherwise unremarkable excepting an area of redness with edema on the left forehead, including and just above the eyebrow.  Eye not involved, no pain with eye movement, no visual changes.  Reddened area feels firm, not fluctuant, and is minimally tender.

A CT scan was obtained, with the above finding(s).

Your challenge: What’s wrong?  What’s the eponym?

*= in the extended entry


(We see this a lot in the ED: the knowledge that ‘something is wrong, otherwise my doctor wouldn’t have ordered an MRI/ head CT/ Sono/ whatever begins to work on that anxiety center, and they come to the ED, unable to wait. Somethimes this is reasonable, mostly less-so, but when in their shoes I find it had to be too harsh about).

Answer: As several guessed, it’s Pott’s Puffy Tumor! Thanks for playing.

9 thoughts on “Another Name that Diagnosis

  1. isn’t this an osteomyelitis of the frontal bone? i can see fracture of the frontal bone..with soft tissue swelling.

  2. Pott’s Puffy Tumor- osteomyelitis of frontal bone secondary to fracture of frontal sinus

  3. My 5 yr old had Pott’s Puffy tummor last summer. He had to have the affected bone in the forehead removed and was on IV antibiotics for 8 weeks. He bumped his for head on the very spot in Feb. and it was found June. Also, he was born with a cleft lip and the Dr. felt that he may have had some sort of abnormality in the sinus area that allowed the infection to get in. He is fine now. He has a great scar, it is a good thing his curly hair covers it well.

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