Case Report of Thyroid Abscess in a Patient with Multinodular Goiter

Abstract

We present the case of a 45-year old auxiliary nurse referred because of a three-year history of multinodular goiter that in a few days before presentation increased in size and became very painful with associated hoarseness, and fever. She was treated for pulmonary tuberculosis (PTB) 2 years earlier. She had no thyrotoxic or hypothyroid symptoms and had no history of hypertension or diabetes. Her last confinement was 1985, though still premenopausal. The goiter progressively became bigger, more painful (with little relief from generous analgesic) and fluctuant. A diagnostic aspiration yielded significant pus collection that was sterile on culture. An incision and drainage was done which drained copious amounts of pus. She had antibiotics and was subsequently discharged. Her thyroid function test showed euthyroid values. The thyroid ultrasound scan showed grossly enlarged and heterogenous thyroid gland, which had irregular ill-defined wall margins. Her fine needle aspiration cytology (FNAC) report following drainage of the abscess showed features of a benign thyroid mass. Chest X-ray revealed no active tuberculous lesions. Subsequent follow-up at the outpatient clinic revealed a drastic reduction in the size of the goiter. Keywords: thyroid abscess, multinodular goiter, FNAC