| Pituitary adenoma apoplexy with initial presentation mimicking bacterial meningoencephalitis: a case report. | |
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MedLine Citation:
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PMID: 19555639 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Wen-Yi Huang; Yu-Yi Chien; Chia-Lun Wu; Wei-Chieh Weng; Tsung-I Peng; Hsien-Chih Chen |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 27 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-06-26 Completed Date: 2009-07-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 517.e1-4 Citation Subset: IM |
Affiliation:
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Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan 204, Republic of China. wenyihuang2003@yahoo.com.tw |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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