A Rare Primary Pituitary Abscess Caused by Cutibacterium Acnes

Area of Science:

• Endocrinology
• Neurosurgery
• Infectious Diseases

Background:

• Pituitary abscess is a rare, life-threatening condition, often misdiagnosed due to overlapping symptoms with other pituitary lesions.
• Preoperative diagnosis is challenging, with most cases identified intraoperatively or postoperatively.

Observation:

• A 60-year-old woman with diabetes presented with headache, fever, and vomiting, later diagnosed with hypopituitarism.
• MRI revealed a sellar lesion with suprasellar extension, prompting endoscopic endonasal transsphenoidal surgery.
• Intraoperative findings included pus, leading to the identification of Cutibacterium acnes infection.

Findings:

• Culture confirmed Cutibacterium acnes as the causative agent of the primary pituitary abscess.
• Histology showed nonneoplastic pituitary tissue with chronic inflammation.
• The patient recovered well following surgical resection and antibiotic therapy.

Implications:

• This case highlights the first reported instance of primary pituitary abscess due to Cutibacterium acnes in an adult.
• Emphasizes the importance of considering pituitary abscess in differential diagnoses, despite its rarity.
• Successful treatment relies on prompt surgical intervention and appropriate antibiotic management for favorable prognosis.