Browsing by Author "Guarda, F.J."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Rathke’s cleft cyst infections and pituitary abscesses: case series and review of the literature
    (Springer, 2021) Aranda, F.; García, R.; Guarda, F.J.; Nilo, F.; Cruz, J.P.; Callejas, C.; Balcells Marty, María Elvira; González, G.; Rojas, R.; Villanueva, P.
    Purpose: Pituitary abscesses (PAs) are a rare clinical entity which may arise from normal pituitary tissue or underlying lesions within the gland. Rathke’s cleft cysts (RCCs) are not commonly associated with the development of PA. Methods: Retrospective chart review of three patients with PAs within RCCs at a single university center and review of the literature. Results: Three cases are reported. The first case presented with fever and headache and a history of prior surgery due to RCC and a recent respiratory tract infection. The second case had a history of recent skin infections and presented with sudden onset headache and hypopituitarism. In the third case, chronic visual field impairment prompted an ophthalmologic evaluation resulting in a diagnosis of an adenoma and an infected RCC. In all three cases, an endoscopic endonasal approach was performed to drain infected tissue and allowed microbiological identification of gram-positive cocci, followed by treatment with antibiotics for at least three weeks. Cases in the literature are scarce and the diagnosis is usually made intraoperatively due to non-specific manifestations and imaging. PAs arising from underlying pituitary lesions are less common than primary PAs. Differential diagnosis should include pituitary apoplexy, hypophysitis and other cystic lesions. Conclusion: PAs occurring in RCCs are infrequent. Clinical manifestations are commonly subacute, without septic symptoms. Imaging is usually non-specific. Preoperative diagnosis is infrequent and a broad differential diagnosis should be considered. Empirical antimicrobial therapy should be initiated and adjusted after obtaining cultures to reduce the rate of recurrence and improve clinical outcomes.