A Case Report of Recurrent Primary Pituitary Abscess: Challenges in Diagnosis and Treatment
Endocrine, Metabolic and Immune Disorders - Drug Targets, cilt.25, sa.14, ss.1205-1210, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 14
- Basım Tarihi: 2025
- Doi Numarası: 10.2174/0118715303338996241021094336
- Dergi Adı: Endocrine, Metabolic and Immune Disorders - Drug Targets
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1205-1210
- Anahtar Kelimeler: Diabetes insipidus, hypopituitarism, primary pituitary abscess, recurrent, visual field deficit, endoscopic endonasal transsphenoidal surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Primary pituitary abscess is a rare disease with no specific symptoms for pituitary abscess alone. A preoperative diagnosis is quite challenging due to unclear imaging findings. Case Presentation: We report the case of a patient with a pituitary lesion who presented with hypopituitarism, diabetes insipidus, and visual field defect and was misdiagnosed as a possible cystic pituitary adenoma. Endoscopic endonasal transsphenoidal surgery (ETSS) was performed, and surprisingly, only pus was found, and complete resection of the lesion was achieved. Coagulase-negative staphylococci were detected in the culture, and appropriate antibiotic therapy was administered for six weeks. Diabetes insipidus and hypopituitarism did not improve. One year later, the abscess recurred, and a second operation with complete resection was performed. Conclusion: Knowledge of primary pituitary abscess, a rare infectious disease, is essential for early detection and successful treatment. Most patients have a chronic and silent prediagnostic course with symptoms that are not specific to pituitary abscess alone. The primary treatment option is EETS, followed by long-term, relevant antibiotics. The disease can be resistant and recur despite appropriate treatment, especially in patients with risk factors. Therefore, long-term follow-up of patients is essential.