Open Journal of Pediatrics > Vol.3 No.2, June 2013

Richard H. Schwartz, Carla Zingariello, Rebecca Levorson, John S. Myseros, Riva Kamat, Theodore W. Fetter

Department of Neurosciences, Division of Neurosurgery, Children’s National Medical Center, Washington DC, USA.
Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, USA.
Department of Surgery, Section of Otolaryngology—Head-Neck Surgery, Inova Fairfax Hospital for Children, Falls Church, USA.

Pott puffy tumor is almost always associated with an outward extension of suppurative acute frontal sinusitis. Pathogenesis includes osteomyelitis of the frontal bone with local spread of the infection to the outer cortex and termination of the suppurative process in a frontal subgaleal abscess. An unusual ectopic location of Pott puffy tumor is the tempo-parietal subgaleal space, located exterior to the squamous portion of the temporal bone. In this location, Pott puffy tumor is considered a suppurative complication of otomastoiditis. Reported here is a 4-year-old boy who developed amoxicillin-resistant acute otitis media, silent mastoiditis, temporal bone subperiosteal abscess, subgaleal abscess, and an epidural abscess. He had several fenestra of the tegmen mastoideum as a result of osteiitis of the temporal bone, which we believe permitted spread of the oto-mastoiditis to temporal bone, subgaleal space, and epidural space. Surgical specimens obtained from the middle ear and subgaleal abscess after 24-hours of intravenously-administered combination antibiotic therapy did not reveal any aerobic or anaerobic bacterial pathogens. This is only the second such pediatric case that we found during a careful search of the literature.

Pott Puffy Tumor; Epidural Abscess; Subgaleal Abscess

Schwartz, R. , Zingariello, C. , Levorson, R. , Myseros, J. , Kamat, R. and Fetter, T. (2013) Pott puffy tumor in an unusual location. Open Journal of Pediatrics, 3, 147-150. doi: 10.4236/ojped.2013.32026.