Key characteristics of macroprolactinomas complicated bacterial meningitis before medical or surgical management, including this case, are presented in Table 2. Though MEN1-associated prolactinomas tend to be larger and are more likely to be locally invasive than sporadic prolactinomas [3], this appears to be the first reported case of MEN1 diagnosed with a macroprolactinoma extending outside the sella turcica and presenting as bacterial meningitis. Here, MEN1 is linked to bacterial meningitis.