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A pituitary abscess masquerading as recurrent hypernatremia and aseptic meningitis.
- Source :
-
BMJ case reports [BMJ Case Rep] 2012 Jun 29; Vol. 2012. Date of Electronic Publication: 2012 Jun 29. - Publication Year :
- 2012
-
Abstract
- Pituitary abscess is a rare condition. In the setting of multiple surgical interventions, the risk of its development increases. A 49-year-old man presented with episodes of altered mental status. He had two surgeries for a recurrent suprasellar arachnoid cyst. The second surgery was complicated by a persistent cerebrospinal fluid (CSF) leak that required two repairs following which he developed panhypopituitarism and central diabetes insipidus. Twelve months after his last surgery he was diagnosed with aseptic meningitis. This was followed by recurrent hospitalisations for severe hypernatremia blamed on poor medication compliance. He was subsequently hospitalised for the evaluation of a febrile illness. Brain MRI showed ventriculitis and enhancement of the sella. Exploratory surgery revealed a purulent collection in the sella and a mucosal graft which had been used to repair the CSF leak. After drainage of pus and replacement of the graft he recovered completely but requiring life-long hormonal replacement.
- Subjects :
- Arachnoid Cysts surgery
Brain Abscess diagnosis
Brain Abscess etiology
Cerebrospinal Fluid Leak
Cerebrospinal Fluid Rhinorrhea etiology
Cerebrospinal Fluid Rhinorrhea surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pituitary Diseases diagnosis
Pituitary Diseases etiology
Brain Abscess complications
Hypernatremia etiology
Meningitis, Aseptic etiology
Pituitary Diseases complications
Postoperative Complications diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 2012
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 22751424
- Full Text :
- https://doi.org/10.1136/bcr-2012-006436