Table 2

Summary of pituitary abscess management

Pituitary abscess management
Signs/symptomsMore common: headache, anterior pituitary dysfunction, visual field deficit, diabetes insipidus
Less common: fever, meningismus
Imaging findingsHigh intensity on T2-weighted images, peripheral enhancement with gadolinium contrast
Common organismsCommon: gram-positive cocci (Staph and Strep species)
Less common: gram-negative rods, fungal organisms
TreatmentSurgical: trans-sphenoidal surgery for drainage
Pharmacologic: empiric ceftriaxone (alternatives: cefotaxime or cefepime) with metronidazole
Vancomycin if concern for Staphylococcus aureus
PrognosisMortality: 10% with therapy
Recurrence: <13%
Hormone recovery: 25%
Follow-upMRI of pituitary, visual field examination and biochemical evaluation 3, 6 and 12 months post surgery
  • Adopted from references 1–4.