Recurrent fever of unknown origin, coma, and meningismus due to a leaking craniopharyngioma.

Abstract

A cyclic leaking craniopharyngioma was found to be the source of recurrent fevers, meningismus, and coma. A sterile persistent neutrophilic pleocytosis with normal glucose and protein was the only clue in an extensive workup. Three head computed tomographic scans, including double contrast with 5-mm cuts, failed to locate the large suprasellar cyst outlined finally by head computed tomographic scan with metrizamide. A handful of case reports exist about leaking central nervous system cysts, but their presentation tended to be different: increased protein, lymphocytosis, and positive cranial imaging. It is believed this is a unique case that adds to the spectrum of chronic neutrophilic meningitis.

• Authors: D W Krueger, E B Larson
• Journal: The American journal of medicine (Am J Med) Vol. 84 Issue 3 Pt 1 Pg. 543-5 (Mar 1988) ISSN: 0002-9343 [Print] United States
• PMID: 3348255 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Coma (etiology)
• Craniopharyngioma (complications, diagnostic imaging)
• Fever of Unknown Origin (etiology)
• Humans
• Male
• Meningism (etiology)
• Pituitary Neoplasms (complications, diagnostic imaging)
• Tomography, X-Ray Computed