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Case Reports
. 2010 Jul 23:2010:bcr0620091945.
doi: 10.1136/bcr.06.2009.1945.

An uncommon cause of recurrent pyogenic meningitis: pituitary abscess

Rama Walia  1 , Anil Bhansali, Pinaki Dutta, G Shanmugasundar, Kanchan Kumar Mukherjee, Vimal Upreti, Ashim Das
Affiliations
Case Reports

An uncommon cause of recurrent pyogenic meningitis: pituitary abscess

Rama Walia et al. BMJ Case Rep. .

Abstract

The authors report a 36-year-old male who presented with headache and hypopituitarism, and MRI revealed a ring enhancing lesion with pituitary stalk thickening. During follow-up, he presented with recurrent pyogenic meningitis with persistence of the lesion, therefore a diagnosis of pituitary abscess was considered. He underwent trans-sphenoidal surgery (TSS) with evacuation of pus and received antibiotic treatment for the same. After this he remarkably improved and had no recurrence of symptoms. He is on levothyroxine, glucocorticoids and testosterone replacement therapy for his respective hormone deficits.

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Conflict of interest statement

Competing interests None.

Figures

Figure 1
Figure 1
Pituitary MR T1 weighted contrast enhanced coronal section showing peripheral ring enhancement with central heterogeneous intensity and stalk thickening suggestive of pituitary abscess.
Figure 2
Figure 2
Histopathology of the pituitary tissue showing neutrophilic infiltrates with coagulative necrosis. In background haemosiderin laden macrophages are seen suggestive of old pituitary haemorrhage.
Figure 3
Figure 3
Pituitary MR T1 weighted contrast enhanced coronal section after trans-sphenoidal surgery showing postoperative changes.
See this image and copyright information in PMC

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