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2011, Number 5

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Rev Fac Med UNAM 2011; 54 (5)

Hypophyseal abscess: A case

González-Ibarra FP, Guzmán-Astorga CP, Leyva- Álvarez EA, Hernández-Félix CP, Estevan-Ortíz PD, Llanos-Navidad MG

Language: Spanish
References: 15
Page: 34-38
PDF size: 156.49 Kb.


ABSTRACT

Pituitary abscesses are defined as the affection of the pituitary gland by an intrasellar suppurative process caused by an infectious agent. Pituitary abscesses represent less than 1% of the pathologies of the sellar region, the clinical manifestations are due to pituitary dysfunction or mass effect. The diagnosis in most of the cases is only after transsphenoidal drainage which is the therapeutic approach of choice, being underdiagnosed and becoming a disease with high mortality if the right and appropriate treatment is not instituted. Case report. A case of a 38-year-old-female patient with amenorrhea of one year of evolution, galactorrhea, headache and visual field deficits manifested by bitemporal hemianopsia is reported. Magnetic resonance imaging showed an image compatible with pituitary adenoma, a transsphenoidal approach was performed and histopathologic report confirmed a brain abscess. Antibiotic therapy was empirically started with vancomycin, metronidazole and ceftriaxone at meningeal doses, failed to get the agent in cultures. Conclusions. Pituitary abscesses are a potentially curable disease that present as a sellar mass, most receive the appropriate therapy by transsphenoidal approach and in most of the cases this procedure gives the definitive diagnosis and treatment simultaneously.


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