Rhinocerebral Mucormycosis Manifested as Pott’s Puffy Tumor

Abstract

Background: Pott’s puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. We report a case of rhinocerebral mucormycosis manifested as Pott’s puffy tumor. This is the first case report of Pott’s puffy tumor caused by mucormycosis in Korea, to the best of our knowledge. Case Report: A 64-year-old diabetic woman presented with headache and altered mental status. MRI and CT of the brain showed sinusitis and intracerebral hemorrhage with diffuse leptomeningeal enhancement. Cerebrospinal fluid study revealed pleoyctosis. Her medical condition deteriorated despite administration of vancomycin and ceftriaxone. Follow-up MRI and CT showed a subperiosteal abscess and osteomyelitis in the left frontal area, suggestive of Pott’s puffy tumor. We performed surgical debridement of the lesion. Histological findings of the lesion were compatible with mucormycosis. We administered amphotericin B intravenously for nine weeks and posaconazole orally for additional four weeks. The patient improved and was discharged to home after three months. Conclusion: Rhiniocerebal mucormycosis can present as Pott’s puffy tumor. Early surgical intervention and administration of anti-fungal agents are warranted for the treatment of Pott’s puffy tumor due to mucormycosis. Key Words: Pott’s puffy tumor; Mucormycosis; brain abscess