title: Pituitary tumor apoplexy presenting as infective meningoencephalitis.
abstract: We report on a case of a 80-year-old man who developed progressive drowsiness with headache, fever and signs of meningeal irritation 2 days after a head trauma. Suspecting an infective meningoencephalitis, the patient was treated with wide spectrum antibiotic and antiviral therapy. Brain CT scan revealed a previously unknown pituitary expansive lesion. A brain MRI study confirmed the presence of an intrasellar lesion, which presented remarkable contrast ring enhancement, and showed non-specific inflammatory tissue on the clivus, possibly responsible of the clinical features of sterile meningitis. A biopsy proven diagnosis of pituitary apoplexy was made. This case highlights MRI as an important investigation for earlier recognition of pituitary apoplexy that can present with a clinical picture resembling an infective meningoencephalitis.
authors.affiliation: Department of Neurosciences, University of Padova Medical School, Via Giustiniani 5, 35128 Padova, Italy. annachiara.cagnin@unipd.it
authors.forename: Annachiara
authors.initials: A
authors.lastname: Cagnin
authors.forename: Andrea
authors.initials: A
authors.lastname: Marcante
authors.forename: Enrico
authors.initials: E
authors.lastname: Orvieto
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000473:pathology*; D010899:Pituitary Apoplexy / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000473:pathology*