Discharging sinus of neck after thyroid surgery:A rare case report

Abstract

There are a number of complications after thyroid surgery such as compressing hematoma, tracheomalacia, wound infection, damage to the recurrent laryngeal nerve or superior laryngeal nerve, hypothyroidism, hypocalcemia, scar formation, and thyroid storm, but discharging skin sinus of the neck is a rare complication. We report a case of discharging pus sinus of the neck after hemithyroidectomy for 1 year; pus culture was positive for Pseudomonas aeruginosa. Thyroid function test was normal. Ultrasonography disclosed branching sinus tracts and right lobe thyroid nodule and the left lobe not visualized. Sinus tracts' excision surgery was done. Histopathology report revealed fibrocollagenous stroma with clusters of epithelioid cells, histiocytes, Langhans giant cells, and chronic inflammatory cells with foci of caseous necrosis. The diagnosis of thyroid tuberculosis (TB) was therefore made. Patient was put on isoniazid, rifampicin, ethambutol, and pyrazinamide. She responds well. Although seldom observed, TB should be kept in mind in the differential diagnosis of discharging sinus of neck.