Pituitary Apoplexy Mimicking Meningitis

Pituitary apoplexy is a rare but life-threatening disorder. Clinical presentation of this condition includes severe headaches, impaired consciousness, fever, visual disturbance, and variable ocular paresis. The clinical presentation of meningeal irritation is very rare. Nonetheless, if present and associated with fever, pituitary apoplexy may be misdiagnosed as a meningitis. We experienced a case of pituitary apoplexy masquerading as a meningitis. A 42-year-old man presented with meningitis associated symptoms and initial imaging studies did not show evidence of intra-lesional hemorrhage in the pituitary mass. However, a follow-up imaging after neurological deterioration revealed pituitary apoplexy. Hereby, we report our case with a review of literatures.

[1]  A. Cagnin,et al.  Pituitary tumor apoplexy presenting as infective meningoencephalitis , 2012, Neurological Sciences.

[2]  T. Peng,et al.  Pituitary adenoma apoplexy with initial presentation mimicking bacterial meningoencephalitis: a case report. , 2009, The American journal of emergency medicine.

[3]  E. Laws Pituitary Tumor Apoplexy: A Review , 2008, Journal of intensive care medicine.

[4]  W. Selman,et al.  Analytic Review: Pituitary Tumor Apoplexy: A Review , 2008, Journal of intensive care medicine.

[5]  W. Selman,et al.  Pituitary tumor apoplexy: characteristics, treatment, and outcomes. , 2004, Neurosurgical focus.

[6]  L. Baden,et al.  "Images in clinical medicine". , 2001, Connecticut medicine.

[7]  M. N. Lassman,et al.  Images in clinical medicine. Pituitary apoplexy. , 2000, The New England journal of medicine.

[8]  H. Randeva,et al.  Classical pituitary apoplexy: clinical features, management and outcome , 1999, Clinical endocrinology.

[9]  J. Lindholm,et al.  Pituitary apoplexy with sterile meningitis , 1986, Acta neurologica Scandinavica.

[10]  M. Harrison,et al.  Pituitary apoplexy and haemorrhage into adenomas. , 1986, Postgraduate medical journal.

[11]  R. D. Adams,et al.  Acute degenerative changes in adenomas of the pituitary body--with special reference to pituitary apoplexy. , 1950, Journal of neurosurgery.