Diagnosis and management of pituitary abscess: a review of twenty-four cases

Abstract

Antibiotic therapy is suggested for patients who have symptoms of sepsis, or for patients in whom specific organisms are identified from cultures obtained during surgery. The transsphenoidal approach is recommended over open craniotomy for surgical drainage.

Pituitary Abscess Mimicking a Pituitary Adenoma Presenting with Secondary Amenorrhea and Blurring of Vision: A Case Report

“…5 According to Fuyi, a post gadolinium rimenhancing mass on MRI is noted in 64% of the patients with pituitary abscess. 6 The MRI findings observed in our patient were a combination of the imaging features described in the two reviews mentioned. The MR image showed a high intensity signals on T2-weighted images and a rim enhancing mass.…”

“…There was no mention about improvement of amenorrhea in the remaining two patients. 6 In a case series done by Lemoncito et al, two cases of pituitary abscess also presented with persistent amenorrhea despite surgical drainage of the abscess after 3 and 6 months of follow up. 7 Our patient presented with panhypopituitarism, and left temporal hemianopsia.…”

“…However, these findings are not specific for a pituitary abscess.. Differentials of rim-enhancing mass may include Rathke's cleft cysts, cystic craniopharyngiomas or cystic adenoma. 6 There seems to be no specific diagnostic features that will help in making a diagnosis of a pituitary abscess pre-operatively.…”

“…2,3,6 However there are two cases wherein the isolated gram-positive cocci did not grow in the culture, 5 The gram stain of the patient's abscess showed polymorphic neutrophils 0-1 /OIF and Gram-positive cocci 0-1/OIF; but there was no growth in the abscess culture. There were also no acid-fast bacilli seen and TB PCR was negative.…”

Pituitary Abscess Mimicking a Pituitary Adenoma Presenting with Secondary Amenorrhea and Blurring of Vision: A Case Report

“…6 Together with the clinical findings, the result of the MRI can be useful to guide appropriate management. Prognosis is generally good after drainage and antibiotic therapy.…”