FRI501 A Rare Case Of Acute Suppurative Thyroiditis

Abstract

Abstract Disclosure: V. Gupta: None. Acute Suppurative thyroiditis is an uncommon however potentially life threatening condition. It is often diagnosed in children due to a congenital association with pyriform sinus fistula. About 8% of cases have been reported in adults primarily in the immunocompromised population. Herein, we report a case of a 35-year-old African American male who presented with a two day history of sore throat, neck pain and swelling with odynophagia. Initial workup revealed a suppressed TSH and elevated free T4. CT imaging of the neck was concerning for a retropharyngeal fluid collection and thyroiditis. Blood cultures grew Methicillin Sensitive Staphylococcus Aureus. He was treated with atenolol, methimazole, broad spectrum empiric IV antibiotics and IV steroids however he remained febrile, tachycardic and tachypneic. Repeat imaging identified the interval development of a possible thyroid abscess. Multiple attempts were made to drain the abscess with fluid cultures confirming MSSA and the diagnosis of acute suppurative thyroiditis. Early diagnosis of acute suppurative thyroiditis is essential as delayed recognition can increase the risk for adverse events including morbidity and mortality. This unique case highlights the importance of the clinician thoroughly evaluating the patient and recognizing an uncommon presentation of thyroiditis. This leads to prompt treatment for a condition that without timely intervention, can lead to fatal outcomes.