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What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery.

Am J Emerg Med

January 2025

Department of Emergency Medicine, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America. Electronic address:

Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache.

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