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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
Summary
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.
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