Pott's puffy tumor in an adolescent: Early recognition to prevent intracranial complications

Pott’s puffy tumor (PPT) is a rare but potentially life-threatening complication of frontal sinusitis that may present with nonspecific symptoms and lead to delayed diagnosis in the emergency setting. We report a 16-year-old male who presented to the emergency department with progressive midline forehead swelling and headache, initially misdiagnosed as acne at an urgent care clinic. Contrast-enhanced computed tomography revealed frontal subgaleal edema and complete opacification of the left osteomeatal unit consistent with PPT without intracranial extension. The patient underwent urgent endoscopic sinus drainage and intravenous antibiotic therapy with complete clinical recovery. Why Should an Emergency Physician Be Aware of This? PPT can mimic benign conditions such as acne or cellulitis, particularly in adolescents, resulting in delayed diagnosis and increased risk of intracranial complications. Early recognition and prompt imaging in patients with forehead swelling and sinus symptoms are essential to initiate timely surgical and antimicrobial management and prevent morbidity.