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Pituitary apoplexy mimicking meningitis

Keun Oh1, Jang-Hee Kim2, Jin-Wook Choi3

  • 1Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.

Brain Tumor Research and Treatment
|June 7, 2014
PubMed

Insights

Pituitary apoplexy, a rare condition, can mimic meningitis symptoms like fever and headache. Early diagnosis is crucial, as initial imaging may not reveal the pituitary hemorrhage, necessitating follow-up for accurate diagnosis.

Area of Science:

  • Neuroendocrinology
  • Neurology
  • Emergency Medicine

Background:

  • Pituitary apoplexy is a rare, acute endocrine emergency.
  • Symptoms often include severe headache, visual deficits, and altered consciousness.
  • Meningeal irritation is an uncommon presentation, potentially leading to misdiagnosis.

Purpose of the Study:

  • To report a rare case of pituitary apoplexy mimicking meningitis.
  • To highlight the diagnostic challenges in differentiating pituitary apoplexy from meningitis.
  • To review literature on similar presentations.

Main Methods:

  • Case report of a 42-year-old male patient.
  • Initial clinical presentation with meningitis-like symptoms.
  • Serial neuroimaging studies, including follow-up after neurological deterioration.

Main Results:

  • Patient initially presented with symptoms suggestive of meningitis.
  • Initial imaging failed to detect hemorrhage within the pituitary mass.
  • Subsequent imaging confirmed pituitary apoplexy following clinical decline.

Conclusions:

  • Pituitary apoplexy can present atypically, mimicking infectious meningitis.
  • Fever and meningeal signs in pituitary apoplexy can lead to diagnostic delays.
  • High index of suspicion and serial imaging are vital for correct diagnosis.
Keywords:
MeningitisPituitary apoplexy

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