Nocardia Pituitary Abscess in an Immunocompetent Host

✓ Seven cases of pituitary abscess are presented and the relevant world literature is reviewed. An enlarged sella co-existing with bacterial meningitis, or bacterial meningitis coinciding with a known or suspected pituitary tumor should suggest the diagnosis of pituitary abscess. Visual field defects should evoke similar suspicion when present in a patient with meningitis. This reasoning enabled us to make the first reported preoperative diagnosis of pituitary abscess. Therefore, in the management of purulent meningitis, we recommend the following: first, skull films are mandatory; second, if the sella turcica is abnormal, the correct presumptive diagnosis is pituitary abscess; and third, if prompt improvement does not follow appropriate antibiotic therapy, the suspected abscess should be explored and drained via the transsphenoidal approach.

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Chronic Rhizopus Invasive Fungal Rhinosinusitis in an Immunocompetent Host

The Laryngoscope ◽

10.1097/00005537-200409000-00005 ◽

2004 ◽

Vol 114 (9) ◽

pp. 1533-1535 ◽

Cited By ~ 23

Author(s):

Joshua L. Scharf ◽

Ahmed M. S. Soliman

Keyword(s):

Immunocompetent Host ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis

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A Rare Presentation of ConcurrentScedosporium apiospermumandMadurella griseaEumycetoma in an Immunocompetent Host

Case Reports in Pathology ◽

10.1155/2012/154201 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Vivek Gulati ◽

Seun Bakare ◽

Saket Tibrewal ◽

Nizar Ismail ◽

Junaid Sayani ◽

...

Keyword(s):

Subcutaneous Tissue ◽

Sensu Stricto ◽

Scedosporium Apiospermum ◽

Immunocompetent Host ◽

Rare Presentation ◽

Atypical Case ◽

Granulomatous Infection

Mycetoma is a disfiguring, chronic granulomatous infection which affects the skin and the underlying subcutaneous tissue. We present an atypical case of recurrent mycetoma without ulceration, in a 35-year-old immunocompetent male caused byScedosporium apiospermumsensu stricto andMadurella grisea, occurring at two separate anatomical sites.

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Drainage or Packing of the Sella? Transsphenoidal Surgery for Primary Pituitary Abscess: Report of Two Cases

Case Reports in Medicine ◽

10.1155/2009/189304 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3

Author(s):

Soichi Oya ◽

Junichiro Kumai ◽

Taku Shigeno

Keyword(s):

Cerebrospinal Fluid ◽

Transsphenoidal Surgery ◽

Sella Turcica ◽

Cerebrospinal Fluid Leak ◽

Anterior Wall ◽

Rare Clinical Entity ◽

Pituitary Abscess ◽

Abscess Drainage ◽

Postoperative Course ◽

Fluid Leak

The detailed surgical procedure of the transsphenoidal surgery for pituitary abscess has scarcely been described previously because it is a very rare clinical entity. The authors reported two cases of primary pituitary abscess. In case 1, the anterior wall of the sella turcica was reconstructed with the vomer bone after irrigating the abscess cavity, but the sella was not packed by fat for fear of the persistent infection by devascularized tissues. This led to the postoperative meningocele, the cerebrospinal fluid leak, and bacterial meningitis despite the successful abscess drainage. In case 2, tight sellar packing and reconstruction of the sellar wall were performed to avoid these postoperative complications, which resulted in complete drainage and uneventful postoperative course. Although accumulation of more cases is obviously needed to establish the definitive surgical technique in pituitary abscess surgery, our experience might suggest that packing of the sella is not impeditive for postoperative sufficient drainage.

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Strongyloides Colitis in an Immunocompetent Host Transmitted Through Sexual Contact: Report of a Case and Review of the Literature

American Journal of Clinical Pathology ◽

10.1093/ajcp/138.suppl1.101 ◽

2012 ◽

Vol 138 (suppl 1) ◽

pp. A106-A106

Author(s):

Jaclyn F. Hechtman ◽

Mohammad Raoufi ◽

Michael Diaz ◽

James George ◽

Hongfa Zhu

Keyword(s):

Sexual Contact ◽

Review Of The Literature ◽

Immunocompetent Host

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Polymicrobial Sepsis in an Immunocompetent Host due to Self Injection of Urine

Journal of Global Infectious Diseases ◽

10.4103/0974-777x.83545 ◽

2011 ◽

Vol 3 (3) ◽

pp. 322

Author(s):

Senthilkumaran Subramanian ◽

Sweni Shah ◽

Balamurugan Namasivayam ◽

Thirumalaikolundusubramanian Ponniah

Keyword(s):

Polymicrobial Sepsis ◽

Immunocompetent Host

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Case Report: A Great Mimicker of Neoplasm: Pulmonary Cryptococcosis in an Immunocompetent Host After High-Altitude Descent

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0238 ◽

2021 ◽

Author(s):

Keely Johnson ◽

Umaima Dhamrah ◽

Aisha Amin ◽

Joseph Masci

Keyword(s):

New York ◽

High Altitude ◽

Acid Fast Bacillus ◽

Chest Imaging ◽

Immunocompetent Host ◽

Pleuritic Chest Pain ◽

Pulmonary Cryptococcosis ◽

Radiological Findings ◽

Travel History ◽

Fluconazole Therapy

Cryptococcus exposure in certain global regions is common and yet virulence in the immunocompetent host remains rare. Radiological findings of pulmonary cryptococcosis may include nonspecific lung nodules or masses indistinguishable from lung cancer or pulmonary tuberculosis. We present a case of an immunocompetent diabetic female who presented with progressively worsening pleuritic chest pain and cough with travel between Tibet and New York 2 months earlier. Chest imaging demonstrated a large lobulated mass, acid-fast bacillus smears were negative, and our patient underwent pulmonary biopsy, which grew rare budding yeast later confirmed by mucicarmine staining as Cryptococcus. Our patient was successfully treated with fluconazole therapy. We hypothesize that the high altitude of Tibet may allow for clinical latency followed by symptomatic reactivation on descent. A raised index of suspicion for pulmonary cryptococcosis with careful attention to travel history is expected to facilitate timely diagnosis.

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Pituitary abscess in an HIV-1-infected patient

SAGE Open Medical Case Reports ◽

10.1177/2050313x17701374 ◽

2017 ◽

Vol 5 ◽

pp. 2050313X1770137

Author(s):

Hiroyuki Yamazaki ◽

Masayuki Kobayashi ◽

Anamaria Daniela Sarca ◽

Akifumi Takaori-Kondo

Keyword(s):

Central Nervous System Infection ◽

Clinical Findings ◽

Endocrine Function ◽

Visual Field Defects ◽

Magnetic Resonance Imaging Scan ◽

Pituitary Abscess ◽

Laboratory Findings ◽

Cell Counts ◽

Disturbance Of Consciousness ◽

Hiv 1

Objectives: Pituitary abscess is a rare occurrence among pituitary conditions, but one which carries life-threatening potential. An immunocompromised status is a risk factor for the development of a pituitary abscess; however, literature describes only one case among HIV-infected patients. Methods and results: We present here a case of pituitary abscess in an HIV-1-positive patient, who demonstrated a shock status, disturbance of consciousness and generalized skin rash with laboratory findings of hypovolemia, acute inflammatory reaction and blood electrolyte abnormality. We first diagnosed the dermal manifestation as atypical generalized zoster, however, the other clinical findings could not be explained by VZV infection only. Combination with anamnesis, head magnetic resonance imaging scan and endocrine function test helped us to diagnose pituitary abscess. Although the etiology of the pituitary abscess could not be detected, the patient was successfully treated with antibiotics but followed by panhypopituitarism as sequela. Conclusion: A pituitary abscess should be considered in HIV-infected patients with endocrinological abnormalities, visual field defects, and central nervous system infection signs or symptoms, regardless of CD4 T-cell counts.

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