# Recurrent Aseptic Meningitis Revealing Primitive Pituitary Abscess

## TL;DR

A teenage girl with recurring aseptic meningitis was found to have a rare pituitary abscess, highlighting the importance of early diagnosis to prevent severe complications.

## Contribution

This case presents a rare pediatric presentation of primitive pituitary abscess without known risk factors.

## Key findings

- The patient had three episodes of aseptic meningitis before the pituitary abscess was diagnosed.
- Postoperative pan-hypopituitarism occurred despite no microorganisms being isolated.
- Growth velocity remained normal, but somatotropin therapy was initiated at age 17 due to low IGF1.

## Abstract

We report a case of primitive pituitary abscess (PA) in a teenage girl who was admitted on three occasions for acute meningitis. A lumbar puncture revealed aseptic meningitis and the brain MRI showed a well-defined intrasellar space-occupying lesion with suprasellar extension suggestive of macroadenoma. The patient remained free of symptoms between episodes of meningitis however she developed a diabetes insipidus. The diagnosis of PA was established preoperatively but no microorganisms were isolated. Postoperatively she developed pan-hypopituitarism. Her growth velocity remained normal. At the age of 17 years, she was started on somatotropin in view of low insulin-like growth factor-1 (IGF1) level.

This case illustrates an insidious presentation of PA in a child without apparent risk factors and complicated with hypopituitarism. Early diagnosis and treatment are crucial to prevent life-threatening complications and irreversible pituitary dysfunction.