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Case Report
A Rare Case of Pituitary Abscess in a Young Nigerian Woman
1 Consultant, Endocrinology, Diabetes and Metabolism Unit, Department of Medicine, Federal Medical Cen, Nigeria
2 Consultant, Department of Medicine, Abia State University Teaching Hospital, Aba, Abia State, Nigeria
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Ezeani IU
Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Federal Medical Center, PMB 7001, Umuahia 400,
Nigeria
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Article ID: 101062Z01EU2019
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Ezeani IU, Nkpozi MO, Uwanurochi VN, Ogbonna SU. A Rare Case of Pituitary Abscess in a Young Nigerian Woman. Int J Case Rep Images 2019;10:101062Z01EU2019.ABSTRACT
Introduction: Pituitary abscess is a rare condition, which diagnosis is usually made during surgery. An uncommon cause of panhypopituitarism, pituitary abscess has not been reported in Nigeria before now to the best of our knowledge. The objective of this article is to report this first case of pituitary abscess in a young Nigerian woman.
Case Report: A 16-year-old female presented with recurrent generalized convulsion, impaired consciousness, fever, and vomiting of few hours duration. History of a prior severe headache and visual impairment that has lasted three years was given by the mother. Examination revealed a small for age girl who was febrile, dehydrated, and unconscious. Treatment for acute bacterial meningitis was commenced with empirical antibiotics (intravenous Ceftriaxone 1 g 12 hourly for 10 days). With further bouts of seizure and recurrent vomiting, brain computed tomography (CT) scan was done three weeks after onset of illness and it showed widening of the sella turcica and an isodense mass with a well-defined margin (measuring 24 × 44 mm) within the sella turcica. A diagnosis of pituitary macroadenoma was made. Her pituitary hormones profile was within normal range but she had decreased plasma estrogen and morning cortisol. Follow-up assessment at 18 years revealed absence of female secondary sex characteristics, primary amenorrhea, and visual field defects. Intraoperatively, 15 mL of pus was drained from a pituitary abscess accessed via frontal craniotomy. Culture of the abscess yielded Listeria organisms sensitive to Ceftriaxone. Postoperative outcome was good.
Conclusion: Pituitary abscess may present initially with neurological and mass effect symptoms; definitive diagnosis is made during surgery.
Keywords: Bacterial meningitis, Craniotomy, Pituitary abscess, Panhypopituitarism
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Acknowledgments
The case was presented at the 39th Scientific Conference & Annual General Meeting of Endocrine & Metabolism Society of Nigeria, Coal City, 2017.
Author ContributionsNkpozi MO - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ezeani IU - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Uwanurochi VN - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Final approval of the version to be published
Ogbonna SU - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Ezeani IU et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
