ABSTRACT
Pituitary apoplexy is a rare but potentially life-threatening complication of androgen deprivation therapy for prostate cancer. We present a case of a 70-year-old African American male with prostate cancer who developed symptoms of pituitary apoplexy, including hot flashes, nausea, vomiting, and cranial nerve III palsy, following the initiation of leuprolide therapy. Imaging revealed a pituitary adenoma with hemorrhage, and prompt multidisciplinary management was initiated. The patient was managed conservatively with improvement in symptoms. This case highlights the importance of recognizing the potential for pituitary apoplexy in patients receiving GnRH agonist therapy. We discuss the clinical presentation of GnRH agonist induced pituitary apoplexy, emphasizing that clinicians should maintain a high index of suspicion and promptly investigate any new neuro- ophthalmic symptoms in this group of patients. Ultimately, prompt diagnosis and treatment are crucial to mitigate the severity of this complication in patients with prostate cancer undergoing androgen deprivation therapy.
Subject(s)
Pituitary Apoplexy , Prostatic Neoplasms , Humans , Male , Aged , Prostatic Neoplasms/drug therapy , Leuprolide/adverse effects , Pituitary Apoplexy/chemically induced , Pituitary Apoplexy/diagnosis , Pituitary Apoplexy/drug therapy , Antineoplastic Agents, Hormonal/adverse effects , Androgen Antagonists/adverse effects , Androgens/therapeutic useABSTRACT
The complications of wound infections caused by animal related trauma are well known and explored. Of the numerous polymicrobial etiologies, Neisseria animaloris and Pasteurella canis oralis have been reported only in a limited number of cases. This manuscript explores the rare finding of these species in the case of an 83-year-old male with a diabetic foot wound complicated by infection from the saliva of his pet dog. The case highlights the first instance of P. canis oralis without the setting of a penetrating animal bite, emphasizing the vulnerability of open lesions in patients whose comorbidities impair proper wound healing. These bacteria are susceptible to beta-lactams with beta-lactamase inhibitors and can be treated once identified. It is crucial to recognize rare pathogens and initiate appropriate treatment early, and to emphasize proper wound care, especially in the context of pet interactions.
