Filter

Refine by subject

Refine by date

—
  • Print
  • Save
  • Print

Diagnosis and Treatment > Medication

You are looking at 1 - 1 of 1 items for :

  • Methylprednisolone x
  • Ceftriaxone x
Clear All
Raluca Maria Furnica Departments of Endocrinology, Pathology, and Neuroradiology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Search for other papers by Raluca Maria Furnica in
Google Scholar
PubMed Close
,
Julie Lelotte Departments of Pathology, and Neuroradiology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Search for other papers by Julie Lelotte in
Google Scholar
PubMed Close
,
Thierry Duprez Departments of Neuroradiology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Search for other papers by Thierry Duprez in
Google Scholar
PubMed Close
,
Dominique Maiter Departments of Endocrinology, Pathology, and Neuroradiology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Search for other papers by Dominique Maiter in
Google Scholar
PubMed Close
, and
Orsalia Alexopoulou Departments of Endocrinology, Pathology, and Neuroradiology, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Search for other papers by Orsalia Alexopoulou in
Google Scholar
PubMed Close

Summary

A 26-year-old woman presented with severe postpartum headaches. Magnetic resonance imaging (MRI) revealed a symmetric, heterogeneous enlargement of the pituitary gland. Three months later, she developed central diabetes insipidus. A diagnosis of postpartum hypophysitis was suspected and corticosteroids were prescribed. Six months later, the pituitary mass showed further enlargement and characteristics of a necrotic abscess with a peripheral shell and infiltration of the hypothalamus. Transsphenoidal surgery was performed, disclosing a pus-filled cavity which was drained. No bacterial growth was observed, except a single positive blood culture for Staphylococcus aureus, considered at that time as a potential contaminant. A short antibiotic course was, however, administered together with hormonal substitution for panhypopituitarism. Four months after her discharge, severe headaches recurred. Pituitary MRI was suggestive of a persistent inflammatory mass of the sellar region. She underwent a new transsphenoidal resection of a residual abscess. At that time, the sellar aspiration fluid was positive for Staphylococcus aureus and she was treated with antibiotics for 6 weeks, after which she had complete resolution of her infection. The possibility of a pituitary abscess, although rare, should be kept in mind during evaluation for a necrotic inflammatory pituitary mass with severe headaches and hormonal deficiencies.

Learning points:

  • The possibility of a pituitary abscess, although rare, should be kept in mind during evaluation for a necrotic inflammatory pituitary mass with severe headaches and hormonal deficiencies.

  • In a significant proportion of cases no pathogenic organism can be isolated.

  • A close follow-up is necessary given the risk of recurrence and the high rate of postoperative pituitary deficiencies.

Taxonomy:
Clinical Overview, Gland/Organ, Pituitary, Topic, Pituitary, Hormone, ACTH, Cortisol, Prolactin, Condition/ Syndrome, Diabetes insipidus - neurogenic/central, Hypophysitis, Panhypopituitarism, Pituitary abscess, Pituitary hyperplasia, Patient Demographics, Age, Adult, Gender, Female, Ethnicity, White, Country of Treatment, Belgium, Diagnosis and Treatment, Signs and Symptoms, Diabetes insipidus, Headache, Hypopituitarism, Polydipsia, Polyuria, Pyrexia, Investigation, ACTH, Chromogranin A, Cortisol (9am), C-reactive protein, Haematoxylin and eosin staining, Histopathology, Immunohistochemistry, MRI, Prolactin, Surgical biopsy, Urine osmolality, Water deprivation, Intervention, Transsphenoidal surgery, Medication, Antibiotics, Ceftriaxone, Desmopressin, Glucocorticoids, Hydrocortisone, Levothyroxine, Methylprednisolone, Related Disciplines, Surgery, Publication Details, Case Report Type, Unique/unexpected symptoms or presentations of a disease
DOI:
https://doi.org/10.1530/EDM-17-0162
Volume/Issue:
Volume 2018: Issue 1
Open access