A 42-yr-old man presented with fever, headache, and vomiting and reported clear fluid dripping from the nose for 2 months preceding the admission. Imaging demonstrated a large tumor eroding the skull base (Figs. 1 and 2). Prolactin was elevated at 92,000 mIU/liter (normal range 53–360). Cerebrospinal fluid (CSF) culture was negative, but Streptococcus species was grown from blood cultures. After treatment for bacterial meningitis, CSF fistula was surgically repaired. Subsequent pituitary testing was diagnostic of testosterone, cortisol, and GH deficiencies.