A pituitary abscess is rare and can be challenging to diagnose. It may be caused by a broad range of bacteria and fungi.
A secondary pituitary abscess arises from within an existing pituitary lesion.
A primary pituitary abscess arises in a normal pituitary.
Risk factors:
(1) surgery at or near the pituitary
(2) bacteremia
(3) meningitis or sinusitis
(4) CSF rhinorrhea
(5) cavernous sinus thrombophlebitis
(6) bacterial endocarditis
(7) dental infection
(8) immunosuppression/immunodeficiency
Clinical features:
(1) altered mental status
(2) pituitary insufficiency (anterior hypofunction, diabetes insipidus, or both)
(3) headache
(4) change in vision
Imaging studies may show:
(1) a pituitary mass
(2) a pituitary with a rim sign.
Complications:
(1) rupture
(2) hypernatremia
(3) spread of infection within the brain
