Korean J Med.  2011 Jan;80(1):102-107.

A Case of Pituitary Apoplexy Misdiagnosed as Aseptic Meningitis

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. hys@catholic.ac.kr

Abstract

Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident. Although pituitary apoplexy is an emergency, it is often overlooked because it is rare and presents with various signs and symptoms, including those of neurologic and endocrine disorders. We describe a case of pituitary apoplexy misdiagnosed as aseptic meningitis accompanied by acute-onset headache and nausea, followed by fever. Subsequently, it was revealed as pituitary apoplexy by brain magnetic resonance imaging (MRI) performed when the clinical course worsened and ophthalmoplegia developed. We suggest that pituitary apoplexy be included in the differential diagnosis of patients presenting with headache or signs of meningeal irritation; when there is no clinical improvement, prompt steroid treatment should be started, while considering neurological decompression to prevent neurological sequelae.

Keyword

Pituitary apoplexy; Hypopituitarism; Meningitis; Aseptic

MeSH Terms

Brain
Decompression
Diagnosis, Differential
Emergencies
Fever
Headache
Humans
Hypopituitarism
Magnetic Resonance Imaging
Meningitis
Meningitis, Aseptic
Nausea
Ophthalmoplegia
Pituitary Apoplexy
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