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Sinusitis complicated by frontal bone osteomyelitis in a young patient

15-year-old male presented with acute left forehead swelling A(Figure, A, arrow) and tenderness following a one-month history of worsening headache secondary to extensive frontal sinusitis. Imaging showed a scalp abscess, frontal bone osteomyelitis and underlying resolving sinusitis (Figure, B, arrow). Management included abscess drainage and bilateral endoscopic sinus surgery. Streptococcus anginosus was isolated and he completed a 6-week course of intravenous benzylpenicillin.