Pott’s puffy abscess: Moniker change from historical misnomer of Pott’s puffy tumor

Abstract

Frontal bone infection with osteomyelitis and subperiosteal abscess causing local forehead swelling has historically carried the moniker of Pott’s puffy “tumor”, in reference to the original description by Percivall Pott in 1760. In the modern era, the “tumor” component of the term causes confusion, since semantic evolution of this term in common parlance is mistakenly interpreted as neoplastic pathology rather than generalized tissue swelling of infectious etiology. The pathology is subperiosteal abscess with frontal sinusitis, which can typically be treated with small focal surgeries involving abscess drainage, osteomyelitis debridement, and endoscopic endonasal frontal sinus surgery, along with course of antibiotics as infectious pathology. Although if the posterior wall of the frontal sinus is significantly compromised, more extensive frontal sinus obliteration surgery may be required. We present a case report of Pott's puffy tumor with frontal sinus and epidural abscess, diagnosed with CT and MRI, treated with frontal burr hole and endoscopic endonasal surgeries plus antibiotics, and review the literature with proposal of simple terminology change to an updated description as Pott’s puffy “abscess”. Keywords: Pott’s puffy tumor, Frontal bone infection, Epidural abscess