title: Suppurative meningitis: A life-threatening complication in male macroprolactinomas.
abstract: BACKGROUND
  Suppurative meningitis (SM) or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT). Our aim was to analyze its frequency among male macroprolactinomas (MPRL) deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared.
  
  
  METHODS
  We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing.
  
  
  RESULTS
  Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4(th) case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction.
  
  
  CONCLUSIONS
  SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4(th) one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Bab El Oued Hospital, 5Boulevard Said Touati, Algiers, Algeria.
authors.forename: Farida
authors.initials: F
authors.lastname: Chentli
authors.forename: Lina
authors.initials: L
authors.lastname: Akkache
authors.forename: Katia
authors.initials: K
authors.lastname: Daffeur
authors.forename: Meriem
authors.initials: M
authors.lastname: Haddad
authors.forename: Said
authors.initials: S
authors.lastname: Azzoug
keywords: Aggressive tumors; male prolactinomas; suppurative meningitis