Endocrine Abstracts

Introduction: Meningitis is a recognized complication of the treatment of pituitary adenoma. It is usually considered as a peri-operative problem but does need to be considered as a potential complication at other points in the treatment pathway. We present two patients with meningitis where the link to pituitary pathology was originally unrecognized.

Case report:

Patient 2: 41 years old lady, presented with a history of nasal drip under investigation by ENT. Before final diagnosis was made she developed an acute confusional state and meningitis. Her MRI shown an extensive pituitary and infrasellar lesion, the biopsy confirmed a pituitary adenoma with strong staining for prolactin. Interestingly her serum prolactin level was minimally elevated at 900 miu/l. Multiple operation was performed to repair the CSF leak. She is currently managed on cabergoline.

Conclusion: Pituitary adenoma, treated or untreated, can potentially cause meningitis when it is complicated by CSF leak. This diagnosis needs to be considered at any stage and not just the immediate post-operative period. The treatment of choice is by surgical repair of the defect to prevent further reoccurrence.