Year 2020 Vol. 28 No 2




Belarusian Medical Academy of Postgraduate Education1, Minsk,
Vitebsk State Medical University 2, Vitebsk,
Republican Research and Clinical Center of Neurology and Neurosurgery3, Minsk,
The Republic of Belarus

The article presents two clinical observations of a rare pathology pituitary abscess, complicated by the secondary purulent meningitis. Clinical and instrumental examination, as well as hormonal changes indicated a pituitary adenoma. The laboratory tests and magnetic resonance imaging showed no signs of inflammation in the patients body. However, when performing the planned transsphenoidal endoscopic operations, pituitary abscesses were diagnosed. The latter were completely removed, purulent cavities washed with antiseptic solutions. In the first observation, liquorrhea was detected intraoperatively, which required plastic closure of the defect of the Turkish saddle with adhesive compositions. The patient developed secondary purulent meningitis, which was cured by the rational antibacterial therapy. In the second observation, the outflow of the cerebrospinal fluid was not observed intraoperatively. The plastic of the bottom of the Turkish saddle was also made. Antibacterial drugs were prescribed. Both patients were discharged from the hospital, the hormonal background improved. Liquorrhea was not detected during the control examinations. Four months after discharge, the second patient developed secondary purulent meningitis, which required emergency hospitalization. The active tactics of patient management with the use of diagnostic test systems D-lactam and Biolactam allowed quick prescription and correction of effective antibacterial drugs for negative bacteriological analysis. The patient was discharged on the 23rd day without neurologic deficit. These clinical cases are of interest as options for disease-free treatment of rather a rare inflammatory pathology of the pituitary gland.

Keywords: pituitary abscess, meningitis, liquorrhea, antibiotics, beta-lactamase activity, D-lactate
p. 222-232 of the original issue
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Address for correspondence:
210023, Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Neurology and Neurosurgery,
Tel.: +375 29 734 93 36,
Konstantin M. Kubrakov
Information about the authors:
Zhurauliou Vladimir A., PhD, Associate Professor, the Department of Neurology and Neurosurgery, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
Kubrakov Konstantin M., PhD, Associate Professor, the Department of Neurology and Neurosurgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Akmyradov Selimmyrat T., Neurosurgeon, the 1st Neurosurgical Unit, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
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