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