SupplementaryTable 1 Clinical characteristics of the 66 patients with pituitary abscess
No / Age/Sex / Course (mo.) / Clinical presentations / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time(mo.) / Outcome
1 / 43/F / 27 / H/A, DI, nausea, vomiting, amenorrhea, decreased vision / Panhypo / WBC↑,
Neu%↑ / Secondary / Typical / PA / TSS / Negative / 272 / Recurred three times, with three additional TSSs; full recovery
2 / 38/M / 18 / DI, decreased vision / Panhypo / Normal / Secondary / Hyperintense on T1WI, hypointense on T2WI, rim enhancement / Pituitary adenoma / TSS / Negative / 253 / DA treatment for DI for 7 years after TSS; hormone replacement
3 / 44/M / 2 / H/A, nausea, vomiting, dizziness / T↓ / Neu%↑ / Primary / Typical / PA / TSS / Negative / 224 / Hormone replacement
4 / 41/M / 24 / H/A, hypogonadism, decreased vision / Normal / Normal / Primary / Typical / Pituitary adenoma / TSS / Negative / 178 / Full recovery
5 / 54/F / 6 / DI, blurred vision / Panhypo / Normal / Primary / Heterointense on T1WI and T2WI, evident enhanced / Craniopharyngioma / TSS / Negative / 176 / DA treatment for DI for 5 years after TSS; hormone replacement
6 / 43/M / 18 / DI, weakness, anorexia, hypogonadism, decreased vision / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 165 / Hormone replacement
7 / 57/F / 24 / H/A, DI, weakness, anorexia, hemianopia, fever / Panhypo / Normal / Primary / Isointense on T1WI, hyperintense on T2WI / Pituitary adenoma / TSS / Negative / 164 / DA treatment for DI for 2 years after TSS
8 / 48/F / 6 / H/A, DI, nausea, fever / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 156 / Hormone replacement
9 / 20/M / 36 / DI, weakness, hypotension / Panhypo / Normal / Primary / Cystic mass, hypointense on T1WI, isointense on T2WI / Rathke’s cleft cyst / TSS / Negative / 156 / DI fully recovered, hormone replacement
10 / 54/M / 8 / DI, weakness, anorexia, hypogonadism, fever / Panhypo / Normal / Primary / Hypointense on T1WI, hyperintense on T2WI, scattered enhancement / PA / TSS / Negative / 147 / Full recovery
11 / 38/F / 1 / DI, weakness, diplopia, decreased vision, fever / Normal / Normal / Primary / Typical / PA / TSS / Staphylococcus haemolyticus / 145 / DA treatment for DI, hormone replacement
No. / Age/Sex / Course (mo.) / Clinical presentation / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time
(mo.) / Outcome
12 / 55/F / 12 / H/A, nausea, amenorrhea, decreased vision, fever, breast pain / Panhypo / Normal / Secondary / Heterointense on T1WI and T2WI, evident enhancement / Craniopharyngioma / TSS / Pseudomonas fluorescens / 134 / DA treatment for DI for 1 year after TSS; hormone replacement
13 / 38/F / 12 / Amenorrhea / Panhypo / Normal / Primary / Hyperintense on T1WI and T2WI / Pituitary adenoma / TSS / Negative / 133 / Hormone replacement
14 / 42/M / 2 / H/A, decreased vision / Normal / Normal / Primary / Isointense on T1WI, isointense/hyperintense on T2WI / Pituitary adenoma / TSS / Negative / 127 / Full recovery
15 / 54/M / 19 / H/A, DI, decreased vision, fever / Panhypo / Normal / Secondary / Typical / PA / TSS / Negative / 124 / Hormone replacement
16 / 35/F / 1 / H/A, decreased vision / LH↓, E↓, T↓, F↓ / Normal / Secondary / Typical / PA / TSS / Negative / 124 / Still H/A; hormone replacement
17 / 44/M / 6 / DI / Panhypo / Normal / Primary / Typical / Craniopharyngioma / TSS / Negative / 121 / DA treatment for DI; hormone replacement
18 / 19/F / 60 / Amenorrhea / Panhypo / Normal / Primary / Typical / Pituitary adenoma / TSS / Negative / 120 / Irregular menstrual periods; hormone replacement
19 / 61/M / 0.25 / H/A, nausea, vomiting, dizziness, fever, dementia / T↓ / WBC↑,
Neu%↑ / Secondary / Hyperintense on T1WI and T2WI, no enhancement / PA / TSS / Pseudomonas aeruginosa / 116 / Full recovery
20 / 34/M / 2 / H/A, DI / Panhypo / Normal / Secondary / Typical / PA / TSS / Negative / 110 / Hormone replacement
21 / 21/M / 3 / H/A, weakness, decreased vision, fever / GH↑ / WBC↑ / Secondary / Typical / PA / TSS / Negative / 109 / Recurred two times, with two additional TSSs; full recovery
22 / 16/F / 6 / DI, nausea, amenorrhea, growth arrest, chilliness / Panhypo / Neu%↓ / Primary / Hypointense on T1WI, hyperintense on T2WI, heterogeneous enhancement / Craniopharyngioma / TSS / Negative / 108 / DA treatment for DI, hormone replacement
23 / 63/M / 2 / H/A,fever, dizziness / Normal / WBC↑ / Primary / Typical / Pituitary adenoma / TSS / Negative / 104 / Died in 2011 due to chronic renal disease and respiratory failure
No. / Age/Sex / Course (mo.) / Clinical presentation / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time
(mo.) / Outcome
24 / 56/M / 3 / H/A, weakness, nausea, anorexia, hypogonadism / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 104 / VP shunt and three TSSs after the TC; abscess still evident; hormone replacement
25 / 52/F / 2 / H/A, vomiting, dizziness / ACTH↓,
F↓ / Normal / Primary / Hyperintense on T1WI and T2WI, rim enhancement / Pituitary adenoma / TSS / Negative / N/A / Lost to follow-up
26 / 56/M / 24 / Weakness, nausea, vomiting,hypogonadism, decreased vision, fever / Panhypo / Normal / Secondary / Typical / PA / TC / Negative / 88 / Hormone replacement
27 / 42/F / 24 / H/A, amenorrhea, blurred vision / Panhypo / Normal / Secondary / Typical / PA / TSS / Negative / 80 / Recurred, treated with an additional TSS; hormone replacement
28 / 43/M / 2 / H/A, weakness, nausea, hypogonadism, decreased vision, palpitation / T3↓, T4↓, TSH↑ / Normal / Primary / Hypointense on T1WI and T2WI, rim enhancement / Pituitary adenoma / TSS / Negative / N/A / Lost to follow-up
29 / 67/M / 3 / H/A, weakness, anorexia, vomiting, blindness in left eye, fever, unconsciousness / Panhypo / WBC↑,
Neu%↑ / Secondary / Soft tissue signal, heterogeneous enhancement / PA / TC / Aspergillus fumigatus / 74 / CSF leakage and an additional TSS; vision did not recover; hormone replacement
30 / 14/M / 12 / H/A, DI, dizziness / Normal / Normal / Primary / Typical / PA / TSS / Negative / 74 / Full recovery
31 / 26/F / 4 / H/A, DI, nausea, anorexia, fever / Panhypo / Neu%↓ / Primary / Typical / PA / TSS / Negative / 70 / Hormone replacement
32 / 72/F / 12 / DI, decreased vision / Normal / WBC↑,
Neu%↑ / Primary / Sellar mass, rim enlargement / Pituitary adenoma / TSS / Negative / 67 / Full recovery
33 / 59/F / 12 / H/A, DI, anorexia, nausea / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / N/A / Loss to follow-up
34 / 70/F / 24 / Decreased vision, acromegaly facies / GH↑ / Neu%↑ / Primary / Hyperintense on T1WI, heterointense on T2WI / Pituitary adenoma / TSS / Negative / 64 / Full recovery
35 / 43/F / 1 / Fever, nausea, vomiting, dementia / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Acinetobacter baumannii / 60 / Hormone replacement
No. / Age/Sex / Course (mo.) / Clinical presentation / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time
(mo.) / Outcome
36 / 57/F / 10 / H/A, DI, nausea, vomiting, decreased vision / FSH↓, LH↓ / WBC↑ / Primary / Typical / Hypophysitis / TSS / Negative / 60 / Hormone replacement
37 / 23/M / 6 / H/A, weakness, anorexia, hypogonadism, fever / Panhypo / Normal / Secondary / Typical / PA / TSS / Aspergillus fumigatus / N/A / Lost to follow-up
38 / 21/F / 28 / H/A, DI, weakness, nausea, vomiting, decreased vision / Panhypo / WBC↑ / Secondary / Sellar mass, rim enhancement / Pituitary adenoma / TSS / MRSA / 59 / Hormone replacement
39 / 57/M / 4 / H/A, weakness, nausea, vomiting, fever / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / 57 / Hormone replacement
40 / 53/F / 14 / H/A,decreased vision, blindness in right eye / Panhypo / Normal / Secondary / Typical / PA / TC / Aspergillus fumigatus / 54 / Blindness in right eye (did not recover); hormone replacement
41 / 43/F / 0.5 / H/A, nausea, vomiting / E↓, LH↓, P↓, T↓ / Normal / Primary / Hyperintense on T1WI and T2WI, no enhancement / Pituitary adenoma / TSS / Negative / 54 / Hormone replacement
42 / 27/M / 6 / H/A,DI, nausea, dizziness / Panhypo / Normal / Primary / Hyperintense on T1WI and T2WI, elevated chiasm, egg-shell-like annular enhancement / Craniopharyngioma / TSS / Negative / 53 / DA treatment for DI for 3 years after TSS; hormone replacement
43 / 41/F / 49 / DI, decreased vision, bilateral hemianopia, fever / Panhypo / Normal / Secondary / Typical / Rathke’s cleft cyst / TSS / Negative / 52 / Hormone replacement
44 / 42/M / 9 / H/A, weakness, anorexia, decreased vision, dizziness / Panhypo / Normal / Primary / Sellar mass, heterointense on T1WI and T2WI / Craniopharyngioma / TSS / Negative / 51 / Hormone replacement
45 / 60/M / 1 / H/A, weakness, blurred vision, fever / Panhypo / Normal / Primary / Hyperintense on T1WI and T2WI, peripheral enhancement / PA / TSS / Staphylococcus lugdunensis / 50 / Occasional weakness; hormone replacement
46 / 61/F / 1 / H/A / Normal / Neu%↑ / Primary / Typical / Rathke’s cleft cyst / TSS / Negative / 49 / Full recovery
47 / 48/F / 1 / H/A, nausea, vomiting, diplopia, decreased vision / Panhypo / Neu%↑ / Secondary / Typical / PA / TSS / Negative / 48 / Decreased vision (did not improve); hormone replacement
No. / Age/Sex / Course (mo.) / Clinical presentation / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time
(mo.) / Outcome
48 / 63/F / 24 / H/A, weakness, nausea, vomiting, fever, dizziness / Panhypo / Neu%↑ / Primary / Isointense on T1WI and T2WI, solid cystic mass when enhanced / PA / TSS / Negative / 48 / Hormone replacement
49 / 56/M / 10 / H/A,DI, nausea, vomiting, hemianopia, fever / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / 46 / Recurred, treated with an additional TSS; hormone replacement
50 / 75/F / 2 / DI, nausea, vomiting, fever / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 46 / Hormone replacement
51 / 55/F / 6 / H/A, vomiting, fever / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 46 / Hormone replacement
52 / 48/F / 0.5 / H/A, decreased vision / Normal / WBC↑,
Neu%↑ / Primary / Hyperintense on T1WI and T2WI / Rathke’s cleft cyst / TSS / Negative / 44 / Full recovery
53 / 62/M / 2 / H/A, DI, weakness / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / 41 / Hormone replacement
54 / 38/F / 2 / H/A, DI, weakness, nausea, vomiting, anorexia, fever / Panhypo,
GH↑ / Normal / Secondary / Typical / PA / TSS / Negative / 36 / Meningoencephalitis after TSS; recovery after taking antibiotics
55 / 53/F / 1 / H/A, DI, fever / Normal / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / 33 / Full recovery
56 / 23/M / 24 / H/A, DI, weakness, nausea, vomiting, fever / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 32 / DA treatment for DI; hormone replacement
57 / 54/F / 4 / H/A, nausea, vomiting, anorexia, fever / Panhypo / Normal / Secondary / Typical / PA / TSS / Negative / 32 / Hormone replacement
58 / 54/M / 48 / H/A, weakness, decreased vision / Panhypo / Normal / Secondary / Hyperintense on T1WI, hypointense on T2WI / PA / TSS / Negative / 30 / Hormone replacement
59 / 43/M / 24 / H/A, decreased vision, hemianopia / ACTH↓,
F↓ / Normal / Primary / Hyperintense on T1WI and T2WI, no enhancement / Rathke’s cleft cyst / TSS / Gram-negative bacteria / 29 / Decreased vision (did not fully recover); hormone replacement
60 / 50/F / 1 / DI, dizziness / Panhypo / Normal / Primary / Typical / PA / TSS / Negative / 28 / Hormone replacement
61 / 26/F / 8 / DI, weakness, nausea, vomiting, anorexia, amenorrhea, decreased vision, hemianopia, fever / Panhypo / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Negative / 28 / Irregular menstrual periods; hormone replacement
No / Age/Sex / Course (mo.) / Clinical presentation / Endocrine findings / Blood Rt / Classification / MRI / Diagnosis before op. / Op. appro / Organism / Follow-up time
(mo.) / Outcome
62 / 57/F / 36 / H/A / Panhypo / Normal / Primary / Hypointense on T1WI and T2WI, rim enhancement / PA / TSS / Aspergillus fumigatus / 27 / Recurred, treated with an additional TSS; hormone replacement
63 / 32/F / 12 / Amenorrhea, decreased vision, fever / PRL↑ / WBC↑,
Neu%↑ / Primary / Typical / PA / TSS / Gram-negative bacteria / 22 / Full recovery
64 / 26/F / 10 / H/A, amenorrhea / Panhypo / WBC↑,
Neu%↑ / Primary / Hypointense on T1WI, hyperintense on T2WI, no enhancement / Rathke’s cleft cyst / TSS / Negative / 17 / Continued amenorrhea; hormone replacement
65 / 32/M / 1 / H/A, DI, weakness, anorexia, fever / Panhypo / Normal / Secondary / Typical / PA / TSS / Staphylococcus capitis / 17 / Hormone replacement
66 / 45/M / 18 / DI, weakness, hypogonadism, decreased vision, hemianopia / T↓,FSH↓, LH↓, P↓ / Normal / Primary / Typical / Rathke’s cleft cyst / TSS / Negative / 17 / Decreased vision (did not improve); hormone replacement
M male, F female,mo. month, H/A headaches, DI diabetes insipidus, DA desmopressin acetate, RT routine test, Panhypo panhypopituitarism, Op operation, appro approach, TSS transsphenoidal surgery, TC transcranial surgery, PA pituitary abscess, N/A not available, VPventriculoperitoneal, MRSA methicillin-resistant Staphylococcus aureus