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Pediatric Otolaryngology

(1017) Factors Associated with Disease Severity in a Cohort of Pediatric Patients with Pott's Puffy Tumor

Saturday, October 17, 2026

Presenting Author(s)

Allan Lu Lee, BS

Medical Student
George Washington School of Medicine and Health Sciences
Potomac, Maryland, United States

Co-Author(s)

Grace Claire Baisden, MD

Resident
Walter Reed
Chevy Chase, Maryland, United States
Hemali P. Shah, MD

Resident Physician
Georgetown University Hospital
Washington, District of Columbia, United States
SG

Sophie P. Gerndt, MD

Resident Physician
Allegheny Health Network, Pennsylvania, United States
Habib G. Zalzal, MD

Assistant Professor
Children's National Medical Center
Washington, District of Columbia, United States

Senior Author(s)

MP

Maria T. Pena, MD

Professor of Otolaryngology and Pediatrics
Children's National Hospital and The George Washington University Medical Center
Washington, DC, United States
JL

James Leonard, MD

Pediatric Otolaryngologist
Children's National Hospital, District of Columbia, United States

Introduction: The objective is to describe patient and clinical factors associated with disease severity and outcomes in a large cohort of pediatric patients with Pott’s puffy tumor (PPT).

Methods: A retrospective review of pediatric patients diagnosed with PPT at Children's National Medical Center between January 2015 and January 2026 was performed. Patient factors, clinical presentation, laboratory results, CT findings, microbiological data, and interventions were collected. Univariate analyses were performed for statistical evaluation.

Results: Of the 24 patients included, 21 (87.5%) were male with a mean age of 12 (STD: 4.0). All patients received broad spectrum antibiotics, and 14 patients (58.8%) underwent endoscopic surgery while 9 patients (37.5%) underwent combined endoscopic and open procedures. Half the cohort also presented with an epidural abscess (N=12). Epidural abscess patients had a significantly longer average hospital admission compared to those without epidural abscess (13 days vs. 8 days, p=0.02). Epidural abscess patients were significantly younger compared to those without (mean age 136 months vs. 164 months, p=0.05). Streptococcus intermedius was isolated in a larger proportion of patients with epidural abscesses compared to those without (75.0% vs. 41.7%, p=0.05) and was associated with longer hospital stays (mean 12 vs. 8 days, p=0.04). No postoperative complications were found in this cohort.

Conclusions: PPT complicated with epidural abscess was associated with a more severe disease course, particularly in younger patients who may be at higher risk for intracranial extension. The frequent isolation of Streptococcus intermedius suggests a potential microbiological marker for severe disease, as well. These findings highlight the importance of early recognition and support a low threshold for MRI evaluation in high-risk patients to identify intracranial spread, guiding timely intervention and management.