Article Text
Summary
Pituitary abscess is an uncommon pituitary lesion. Its clinical diagnosis can be difficult to distinguish from other pituitary lesions. This pathology is characterised by vague symptoms of headaches, generalised tiredness and hypopituitarism manifestations. A history of recent meningitis, paranasal sinusitis or head surgery can be a suggestive of the source of infection.
A 20-year-old man was admitted to neurosurgery department with complain of headache, fatigue, polyuria, polydipsia, blurred vision and sexual dysfunction. MRI of the head revealed a suprasellar mass that was centrally hyperintense lesion on T2-weighted images with peripheral hypointensity and isointense centrally on T1 images with peripheral hyperintensity images. Treatment of this lesion pituitary abscess was surgical drainage of the pituitary area through a trans-sphenoidal approach and broad spectrum antibiotic therapy with ceftriaxone, metronidazole and vancomycin for 6 weeks. The patient continues to have pituitary insufficiency and treated with oral hydrocortisone.
Although pituitary abscess is a rare condition, it should always be kept in mind when evaluating a patient with hypopituitarism. After the diagnosis, the surgery and antibiotics should be commenced rapidly. The outcome is usually good with proper treatment.
- Endocrine system
- Infections
- Pituitary disorders
- Infection (neurology)
- Neuroimaging
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Footnotes
Contributors JMAS managed the patient from infectious perspective and supervised the writing of the case report. RAMBAA managed the patient from infectious perspective and wrote the case report. MH managed the patient for the neurosurgery perspective.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Hospital Ethical Committee.
Provenance and peer review Not commissioned; externally peer reviewed.