Frontitis: A Case of Successful Diagnosis Despite Absence of Specific Symptoms

Frontitis: A Case of Successful Diagnosis Despite Absence of Specific Symptoms

A 25-year-old woman presented to the clinic with complaints of headache.


The patient reported that the most intense pain was located in the frontal region, especially in the projection of the left frontal sinus. She described the pain as dull, aching, and sometimes throbbing. She also experienced weakness and rapid fatigue.

The painful syndrome worsened in the mornings upon waking and when the woman leaned her head forward. In the upright position, the pain usually subsided but did not completely disappear. Pain relievers only provided temporary relief.

The painful sensations first appeared 5 days before the visit when she got chilled in the cold. On the same day, she developed a fever and took a packet of (TeraFlu). During these days, her temperature periodically rose to 37.5°C, and she managed it with Paracetamol.

The patient grew and developed appropriately for her age. She had no chronic illnesses, harmful habits, or allergies. Her working conditions were safe for health. She had never experienced any injuries or undergone surgery.


At the appointment, the woman felt normal. She weighed 85 kg, was 165 cm tall, had a temperature of 37.4°C, and blood pressure of 120/75 mmHg. Her skin was moist and warm.

The nose appeared normal, but upon palpation and percussion, the patient felt moderate tenderness in the projection of the left frontal sinus. Breathing was not impaired.

Examination of the nose using a mirror showed that the mucous membrane was slightly reddened and swollen, with a thin strip of mucopurulent discharge in the middle nasal passage on the left. The nasal septum was not deviated. The inferior nasal turbinates were enlarged but normalized after decongestion.

Other ENT organs showed no pathology.

X-ray of the paranasal sinuses revealed total reduction of pneumatization of the left frontal sinus, indicating almost no air present.

Left-sided acute purulent frontitis (inflammation of the frontal sinus).

X-ray of the paranasal sinuses


The patient was prescribed a 10-day course of systemic antibacterial therapy combined with nasal glucocorticoid drops. For 5 days, the woman was to use a vasoconstrictor and irrigate the nose with hypertonic solution 2–3 times a day to relieve congestion of the paranasal sinuses.

To facilitate the drainage of pathological secretions from the frontal sinus, she was also prescribed a course of mucolytics.

Within 2–3 days, the patient’s headache subsided, and her temperature returned to normal. Despite this improvement, she continued the course of treatment as prescribed.

After 10 days, there were no signs of inflammation in the nasal cavity, and the woman felt excellent.


This clinical case demonstrates that not all diseases present as described in textbooks. For example, with a symptom such as headache, the patient might have consulted a neurologist or a general practitioner instead of an ENT specialist, leading to a search for the cause elsewhere. Delayed administration of appropriate treatment could have resulted in further complications.