Pituitary abscess (PA) is an acute purulent-inflammatory disease with a high risk of lethal outcome [1, 2, 3]. It was first described by Heslop in 1848 and

M. Simmonds in 1914 (cited in R. A. Hanel et al., 2002 [2]). To date, more than 200 clinical cases of this disease have been described in the world literature. This pathology is presented in publications mainly as isolated cases. PA was rarely accompanied by the development of purulent meningoencephalitis according to published cases [4]. The rare occurrence of PAH makes it difficult to determine the epidemiology of the disease, but it is thought to account for 0.2–1.1 % of all chiasmo-sellar masses — (CSR) [5,6,7].

In children, pituitary abscess is exceptionally rare. Currently, we were able to find 22 publications of primary pituitary abscess in children in the international literature. Most PAs were caused by infection from the Rathke’s pocket cleft cyst. In only a few cases, PAs had a primary pituitary origin [5, 8, 9]. Clinical diagnosis is difficult because there are no specific clinical symptoms or signs of the disease. PA often cannot be distinguished radiologically from other pituitary gland lesions. At disease manifestation, laboratory markers of inflammation (such as increased erythrocyte sedimentation rate, leukocytosis, increased C-reactive protein, and fibrinogen [10, 11] do not exceed reference values). Treatment consists of opening and drainage of the abscess and systemic antibacterial therapy, as well as hormonal replacement therapy.

We publish one case of a primary pituitary abscess confirmed during endoscopic surgery, highlighting the clinical, diagnostic, and therapeutic aspects.

Girl M, 13 years old, vaccinated according to the calendar, acute respiratory infections 1–2 times a year, was not registered in the dispensary. At age 9, against a background of general health, a long fever of 37.0–39.0 degrees was noted; after 4 months, the fever stopped on its own, the cause remains unknown. There were courses of antibiotic therapy, and the situation normalized. At the beginning of March 2020, the whole family fell ill, presumably due to acute respiratory viral infections, had a fever of 37.5, the temperature normalized in 5 days; however, on the 6th day, the patient had repeated fever up to hectic 39.1, headache, took antibiotic therapy of a broad spectrum without pronounced result, on April 23, 2020, the vomiting started, the intensity of headaches increased. The patient underwent an outpatient brain MRI scan, which revealed a suspected pituitary cyst (craniopharyngioma?), on May 26, 2020. The patient came to the Children`s City Clinical Hospital of Moscow on her own, complaining of episodes of elevated body temperature up to hectic levels, repeated vomiting once in 3–4 days, intense headache, not relieved by analgesics, and weakness.