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Iatrogenic Pituitary Abscess

  • Gabriel ZadaEmail author
  • M. Beatriz S. Lopes
  • Srinivasan MukundanJr.
  • Edward LawsJr.

Abstract

Spontaneous pituitary abscesses are rarely encountered; they represent less than 0.6 % of patients with sellar lesions undergoing surgical resection. (See Chap. 51.)

Acquired or iatrogenic pituitary abscesses are also uncommon. They develop rarely following cerebral trauma or transsphenoidal surgery, especially in the presence of a CSF leak. Iatrogenic abscesses are usually bacterial. Risk factors for postoperative pituitary abscess include paranasal sinus disease and sphenoid sinusitis or a spontaneous or traumatic CSF leak. Sepsis is also known to be another inciting factor.

Pituitary abscesses may present clinically with headache, fever, hypopituitarism (85 %), meningitis, diabetes insipidus, visual loss, cranial nerve paresis, altered mental status, and/or toxemia.

Diabetes insipidus is relatively common in patients with sellar abscess, being present in up to 70 % at the time of diagnosis.

The most common offending bacterial organisms are staphylococcus, streptococcus, and pneumococcus species.

Only one third of patients have an increased peripheral white blood cell count.

Keywords

Pituitary Abscess Infection Sella Cerebrospinal fluid leak 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Gabriel Zada
    • 1
    Email author
  • M. Beatriz S. Lopes
    • 2
  • Srinivasan MukundanJr.
    • 3
  • Edward LawsJr.
    • 4
  1. 1.Department of Neurological Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of Pathology (Neuropathology)University of Virginia School of MedicineCharlottesvilleUSA
  3. 3.Department of RadiologyBrigham and Women’s HospitalBostonUSA
  4. 4.Department of NeurosurgeryBrigham and Women’s HospitalBostonUSA

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