Pituitary abscess in an adolescent girl: a case report and review of the literature
-
Ricardo Zegarra-Linares
Abstract
We report the case of a 15-year-old girl who presented with a history of recurrent bitemporal headaches for the last 2 months. In the prior few days, she complained of neck pain, emesis, phonophobia and photophobia, but no fever. Additional symptoms included polydipsia, polyuria and weight gain in the last year. Magnetic resonance imaging (MRI) of the brain demonstrated a cystic sellar and suprasellar mass with peripheral enhancement. Cerebrospinal fluid studies showed pleocytosis. Serum hormone levels were consistent with panhypopituitarism. Transnasal sphenoidotomy was performed, and 2 mL of purulent material was drained, confirming the diagnosis of pituitary abscess. The patient completed 6 weeks of parenteral antibiotics. She improved but continued to require home hormonal replacement therapy. A repeated MRI 3 months later showed abscess resolution. In addition to tumors, pituitary abscess should be considered in children who present with headache and panhypopituitarism, particularly in those who present with signs of meningeal inflammation. Prolonged parenteral antibiotics and surgical drainage are effective.
References
1. Vates GE, Berger MS, Wilson CB. Diagnosis and management of pituitary abscess: a review of twenty-four cases. J Neurosurg 2001;95:233–41.10.3171/jns.2001.95.2.0233Suche in Google Scholar PubMed
2. Bangera S, Chattopadhyay, Singh RK, Al Asousi AA, Joseph E. Primary pituitary abscess with coexisting pyogenic meningitis: an unexpected diagnosis. Am J Med Sci 2013;345:75–7.10.1097/MAJ.0b013e318265a10cSuche in Google Scholar PubMed
3. Dutta P, Bhansali A, Singh P, Kotwal N, Pathak A, et al. Pituitary abscess: report of four cases and review of literature. Pituitary 2006;9:267–73.10.1007/s11102-006-8327-zSuche in Google Scholar PubMed
4. Kaur A, Agrawal A, Mittal M. Presumed pituitary abscess without infectious source treated successfully with antibiotics alone. J Neuro-ophthalmol 2005;25:185–8.10.1097/01.wno.0000177292.06727.9cSuche in Google Scholar PubMed
5. Thiryayi W, Donaldson MH, Border D, Tyagi A. An enhancing pituitary lesion in a young woman: a diagnostic dilemma. J Clin Neurosci 2007;14:286–8.10.1016/j.jocn.2005.12.005Suche in Google Scholar PubMed
6. Zhang X, Li Q, Hu P, Cheng H, Huang G. Two case reports of pituitary adenoma associated with Toxoplasma gondii infection. J Clin Pathol 2002;55:965–6.10.1136/jcp.55.12.965Suche in Google Scholar PubMed PubMed Central
7. Hazra S, Acharyya S, Acharyya K. Primary pituitary abscess in an adolescent boy: a rare occurrence. BMJ Case Rep 2012, published on 19 December 2012, doi:10.1136/bcr-2012-007134.10.1136/bcr-2012-007134Suche in Google Scholar PubMed PubMed Central
8. Kotani H, Abiru H, Miyao M, Kakimoto Y, Kawai C, et al. Pituitary abscess presenting a very rapid progression: report of a fatal case. Am J Forensic Med Pathol 2012;33:280–3.10.1097/PAF.0b013e3182557dcfSuche in Google Scholar PubMed
9. Dalan R, Leow MK. Pituitary abscess: our experience with a case and a review of the literature. Pituitary 2008;11:299–306.10.1007/s11102-007-0057-3Suche in Google Scholar PubMed
10. Danilowicz K, Sanz CF, Manavela M, Gomez RM, Bruno OD. Pituitary abscess: a report of two cases. Pituitary 2008;11:89–92.10.1007/s11102-007-0033-ySuche in Google Scholar PubMed
11. Becker GL, Jr., Knep S, Lance KP, Kaufman L. Amebic abscess of the brain. Neurosurgery 1980;6:192–4.Suche in Google Scholar
12. Zhang X, Sun J, Shen M, Shou X, Qiu H, et al. Diagnosis and minimally invasive surgery for the pituitary abscess: a review of twenty nine cases. Clin Neurol Neurosurg 2012;114:957–61.10.1016/j.clineuro.2012.02.020Suche in Google Scholar PubMed
13. Hanel RA, Koerbel A, Prevedello DM, Moro MS, Araujo JC. Primary pituitary abscess: case report. Arq Neuro-psiquiatr 2002;60:861–5.10.1590/S0004-282X2002000500033Suche in Google Scholar
©2015 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Highlight: Diabetes
- Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
- Maturity-onset diabetes of the young (MODY): an update
- Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
- How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
- Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
- Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
- An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years
- Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study
- Assessment of human cartilage glycoprotein 39 (YKL-40), preptin, and nitric oxide in adolescent patients with type 1 diabetes and its relation to cardiorenal affection
- The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys
- From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma
- Three years of liraglutide treatment offers continuously optimal glycemic control in a pediatric patient with maturity-onset diabetes of the young type 3
- Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
- Transient neonatal hyperinsulinism with adaptation disorders: a report of three cases
- Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
- Alternating hypoglycemia and hyperglycemia in a toddler with a homozygous p.R1419H ABCC8 mutation: an unusual clinical picture
- Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
- Images in pediatric endocrinology
- Benefit of testosterone in pediatric genital trauma
- Original articles
- Attenuated salivary cortisol response after exercise test in children with asthma
- Reliability of pubertal maturation self-assessment in a school-based survey
- Detection of inborn errors of metabolism using GC-MS: over 3 years of experience in southern China
- Assessing biological maturity: chronological age and the pubertal development scale predict free testosterone in adolescent males
- Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls
- Longitudinal changes in C-reactive protein, proform of eosinophil major basic protein, and pregnancy-associated plasma protein-A during weight changes in obese children
- Caries in adolescents in relation to their skeletal status
- Endothelial and metabolic disorders in adolescence: low birth weight is not an isolated risk factor
- Comparison of cortisol samples in the first two weeks of life in preterm infants
- Mutations in BTD gene causing biotinidase deficiency: a regional report
- Patient reports
- Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention
- Hepatoblastoma presenting as precocious puberty: a case report
- Three cases of Wolfram syndrome with different clinical aspects
- L-asparaginase induced hypoglycemia in a case of acute lymphoblastic leukemia: a patient report
- Pyogenic granuloma, an unusual presentation of peripubertal vaginal bleeding. Case report and review of the literature
- Octreotide-associated cholestasis and hepatitis in an infant with congenital hyperinsulinism
- Two novel mutations in the homogentisate-1,2-dioxygenase gene identified in Chinese Han Child with Alkaptonuria
- Pituitary abscess in an adolescent girl: a case report and review of the literature
- Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature
- Consumptive hypothyroidism associated with parotid infantile hemangioma
- Novel mutations in the SLC25A13 gene in a patient with NICCD and severe manifestations
- Short communications
- Tetrahydrobiopterin deficiency among Serbian patients presenting with hyperphenylalaninemia
Artikel in diesem Heft
- Frontmatter
- Highlight: Diabetes
- Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
- Maturity-onset diabetes of the young (MODY): an update
- Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
- How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
- Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
- Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
- An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years
- Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study
- Assessment of human cartilage glycoprotein 39 (YKL-40), preptin, and nitric oxide in adolescent patients with type 1 diabetes and its relation to cardiorenal affection
- The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys
- From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma
- Three years of liraglutide treatment offers continuously optimal glycemic control in a pediatric patient with maturity-onset diabetes of the young type 3
- Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
- Transient neonatal hyperinsulinism with adaptation disorders: a report of three cases
- Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
- Alternating hypoglycemia and hyperglycemia in a toddler with a homozygous p.R1419H ABCC8 mutation: an unusual clinical picture
- Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
- Images in pediatric endocrinology
- Benefit of testosterone in pediatric genital trauma
- Original articles
- Attenuated salivary cortisol response after exercise test in children with asthma
- Reliability of pubertal maturation self-assessment in a school-based survey
- Detection of inborn errors of metabolism using GC-MS: over 3 years of experience in southern China
- Assessing biological maturity: chronological age and the pubertal development scale predict free testosterone in adolescent males
- Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls
- Longitudinal changes in C-reactive protein, proform of eosinophil major basic protein, and pregnancy-associated plasma protein-A during weight changes in obese children
- Caries in adolescents in relation to their skeletal status
- Endothelial and metabolic disorders in adolescence: low birth weight is not an isolated risk factor
- Comparison of cortisol samples in the first two weeks of life in preterm infants
- Mutations in BTD gene causing biotinidase deficiency: a regional report
- Patient reports
- Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention
- Hepatoblastoma presenting as precocious puberty: a case report
- Three cases of Wolfram syndrome with different clinical aspects
- L-asparaginase induced hypoglycemia in a case of acute lymphoblastic leukemia: a patient report
- Pyogenic granuloma, an unusual presentation of peripubertal vaginal bleeding. Case report and review of the literature
- Octreotide-associated cholestasis and hepatitis in an infant with congenital hyperinsulinism
- Two novel mutations in the homogentisate-1,2-dioxygenase gene identified in Chinese Han Child with Alkaptonuria
- Pituitary abscess in an adolescent girl: a case report and review of the literature
- Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature
- Consumptive hypothyroidism associated with parotid infantile hemangioma
- Novel mutations in the SLC25A13 gene in a patient with NICCD and severe manifestations
- Short communications
- Tetrahydrobiopterin deficiency among Serbian patients presenting with hyperphenylalaninemia
