title: Pituitary abscess manifesting as meningitis and photophobia associated with Rathke's cleft cyst in a child. Case report.
abstract: A 12-year-old girl presented with complaints of headache, lethargy, photophobia, and fever. Cerebrospinal fluid examination revealed bacterial meningitis. Magnetic resonance (MR) imaging showed a cystic lesion with peripheral enhancement in the pituitary fossa. The patient underwent transnasal-transsphenoidal surgery (TSS). The diagnosis was pituitary abscess associated with Rathke's cleft cyst. Postoperatively, the patient recovered rapidly. However, recurrence of the pituitary abscess causing meningitis occurred four times and required repeated TSS. She had diabetes insipidus and received hormone replacement. This case requiring repeated emergency surgeries shows that follow-up examinations including MR imaging and pituitary endocrine evaluation are necessary because the rate of recurrence is high in patients with pituitary abscess associated with Rathke's cleft cyst.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sakai
authors.forename: Megumi
authors.initials: M
authors.lastname: Asanuma
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Aoyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D001922:Brain Abscess / Q000150:complications / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D020863:Central Nervous System Cysts / Q000150:complications* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D020795:Photophobia / Q000209:etiology* / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D010900:Pituitary Diseases / Q000150:complications / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D012008:Recurrence; D016896:Treatment Outcome