Document Detail


Pituitary adenoma apoplexy with initial presentation mimicking bacterial meningoencephalitis: a case report.
MedLine Citation:
PMID:  19555639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pituitary apoplexy is a rare but life-threatening disorder. Clinical presentation of this condition includes severe headache, impaired consciousness, fever, visual disturbance, and variable ocular paresis. Signs of meningeal irritation are very rare. However, if present and associated with headache, fever, and pleocytosis, meningeal irritation may lead to misinterpretation as infectious meningoencephalitis. To the best of our knowledge, pituitary apoplexy with an initial presentation mimicking infectious meningoencephalitis had rarely been reported in the literature. Here, we report a 57-year-old man who had acute severe headache, high fever, neck stiffness, disturbance in consciousness, and left ocular paresis. Laboratory data showed leukocytosis, an elevated C-reactive protein level, and neutrophilic pleocytosis in the cerebrospinal fluid. Because bacterial meningoencephalitis was suspected, empiric antibiotic therapy was administered but in vain. Further examinations indicated a diagnosis of pituitary adenoma with apoplexy. After the immediate administration of intravenous corticosteroid supplement and surgical decompression, the patient recovered.
Authors:
Wen-Yi Huang; Yu-Yi Chien; Chia-Lun Wu; Wei-Chieh Weng; Tsung-I Peng; Hsien-Chih Chen
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  27     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-06-26     Completed Date:  2009-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  517.e1-4     Citation Subset:  IM    
Affiliation:
Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan 204, Republic of China. wenyihuang2003@yahoo.com.tw
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MeSH Terms
Descriptor/Qualifier:
Adenoma / blood,  cerebrospinal fluid,  diagnosis*
Biological Markers / blood,  cerebrospinal fluid
Diagnosis, Differential
Diagnostic Errors / prevention & control
Humans
Male
Meningoencephalitis / blood,  cerebrospinal fluid,  diagnosis*
Middle Aged
Pituitary Apoplexy / blood,  cerebrospinal fluid,  diagnosis*
Pituitary Neoplasms / blood,  cerebrospinal fluid,  diagnosis*
Chemical
Reg. No./Substance:
0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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