Sinonasal tuberculosis as an unusual cause for pott’s puffy tumor: a case report

Pott’s puffy tumor (PPT), defined by frontal bone osteomyelitis with a subperiosteal abscess, is a known sequela of bacterial rhinosinusitis. This case report highlights Mycobacterium tuberculosis as a cause for PPT, which had resulted in delayed diagnosis and treatment. Although previously described, extrapulmonary tuberculosis (TB) of the sinonasal cavity is an exceedingly rare cause for atypical PPT. A 76-year-old immunocompromised female with several days of isolated, progressive facial swelling, consistent with PPT, underwent urgent frontal sinus trephination and endoscopic sinus surgery. Intraoperative cultures and histopathology demonstrated Mycobacterium tuberculosis infection. The patient recovered without any complications after surgery and antitubercular therapy. TB is a rare but important differential in atypical PPT, particularly in immunocompromised patients or those with risk factors for TB. Given the nonspecific clinical and radiographic features, diagnosis often relies on a high index of suspicion. Delayed recognition carries significant public health implications, including further transmission and intracranial progression.