Increasing Rate of Pott’s Puffy Tumor Hospitalizations Among US Children

BACKGROUND: Pott's puffy tumor is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess, often with intracranial sequelae. Although complications of sinusitis increased after the pandemic, it is unclear whether rates of Pott's puffy tumor increased. OBJECTIVE: To investigate the rate of Pott's puffy tumor hospitalizations in US children and assess trends in clinical characteristics during 2017-2025. METHODS: We performed a cross-sectional epidemiological study using Epic Cosmos. We included hospitalizations of pediatric patients (aged 0-21 years) at continuously contributing US hospitals during 2017-2025 with a Pott's puffy tumor diagnosis and receipt of systemic antibiotics. We calculated annual Pott's puffy tumor hospitalization rates per 100 000 hospitalizations. We identified patient-level demographic and clinical characteristics and compared these between 2017-2019 and 2022-2025. RESULTS: We identified 601 pediatric patients hospitalized for Pott's puffy tumor during 2017-2025 from 170 hospitals. The hospitalization rate increased from 2.8 per 100 000 hospitalizations in 2017 to 6.0 in 2025. The median age was 12 years, the median length of stay was 7 days, and 33% of patients received care in the intensive care unit, which was similar across time periods. The proportion of patients who underwent surgical procedures increased from 37% in 2017-2019 to 60% in 2022-2025 (P < .001). CONCLUSION: Our findings suggest that, although still a rare diagnosis, Pott's puffy tumor hospitalizations among children have increased, with an increase in surgical intervention. Further investigation into the incidence and the cause of observed increases is warranted.