A Pituitary Abscess Caused by Morganella morganii: A Case Report

Objective: Rare diseaseBackground: Pituitary abscess (PA) is a rare pituitary lesion accounting for less than 1% of all pituitary diseases and is as-sociated with high mortality rates. The non-specific clinical symptoms and radiological features preclude accu-rate diagnosis of the disease. Hence, surgical intervention is still considered the criterion standard method for PA diagnosis. Most PAs occur as a primary disease or due to complications such as surgery, sepsis, and adja-cent inflamed lesions.Case Report: A 53-year-old man presented to the Emergency Department with a headache associated with nausea, vomit-ing, and constipation. The patient had no visual disturbances, polyuria, polydipsia, nocturia, or abnormal dis-charges. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large suprasellar mass. The patient underwent left-side trans-nasal transsphenoidal microscopic surgery for mass removal. An abscess with discharge was noticed and sent for microbiological evaluation, revealing an infection with a commensal enteric bacterium that rarely causes nosocomial infection, known as Morganella morganii. The patient was dis-charged after completing the intravenous antibiotic course and was given oral antibiotics.Conclusions: Pituitary abscess is a rare pituitary lesion. However, taking the history of recent meningitis, sinusitis, and/or surgery may help to reach an early diagnosis, prompt surgical intervention, and vital therapeutic steps to re-duce mortality rates and improve patient's outcomes. PA should always be considered when patients demon-strate signs of pituitary dysfunction associated with signs of infection. Furthermore, antibiotics should be ad-ministered immediately once the PA case is confirmed and should last for at least 6 weeks postoperatively.