allergy

Pott’s Puffy Tumour: a rare but sinister cause of facial swelling

A 27 year old female presented to the emergency department with intermittent central forehead swelling over several months associated with a headache. She was admitted under the medical team as having had a suspected allergic reaction but the diagnosis of a Pott’s Puffy Tumour was quickly made and confirmed through CT and MR imaging. This uncommon condition is related to sinusitis leading to localised abscess formation with osteomyelitis and a subsequent swollen appearance over the affected facial sinus.

This patient’s sinus abscess extended into the epidural space and caused destruction of the anterior and posterior walls of the frontal sinus. The patient was managed with intravenous antibiotics, analgesia and referral to the local ENT team for surgical intervention.

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Angioedema caused by bupropion treatment

Abstract

Reports of urticaria and rash with bupropion are common, with an estimated incidence of 1-4%. Serious adverse reactions, including seizures and angioedema occur less commonly, but may be dose related. Rarely patients present with fever, arthralgia and myalgia resembling a serumsickness reaction. A case of a 30 year-old man presenting with a rash, angioedema, and arthralgia 19 days after commencing bupropion treatment to aid smoking cessation is described. Treatment with antihistamines and steroids, resulted in improvement within 3 hours, and complete resolution after 3 days. Management also included identifying and discontinuing the causative agent. Recent concerns over neuropsychiatric side effects of bupropion are highlighted. The literature is reviewed and recommendations for safer prescribing discussed.

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