Acute Suppurative Thyroiditis In Children Research Articles

Acute suppurative thyroiditis in a 10-year-old child

BACKGROUND: Acute suppurative thyroiditis in children is a rare and potentially life-threatening thyroid disease that requires rapid diagnostics and treatment.
 CLINICAL CASE DESCRIPTION: A clinical case of a 10-year-old girl with a thyroid abscess is described. She had fever, painful neck swelling, sore throat, tachycardia, restricted neck movement, and dysphagia for 6–7 days. The treatment consisted of antibiotic therapy, incision and drainage of the abscess using local ozone therapy. It was found that causative agents were Staphylococcus aureus and Escherichia coli. The girl had a follow-up examination in 9 months after the discharge — there were no signs of thyroid pathology.
 CONCLUSION: Although acute suppurative thyroiditis is extremely rare in children, it occurs sometimes. Since this condition may be associated with a piriform sinus fistula, the child must be examined for it because of the risk of recurrence.

Clinical Analysis of Acute Suppurative Thyroiditis in 18 Children.

ObjectiveTo summarize our clinical experience with the diagnosis and treatment of children with acute suppurative thyroiditis (AST).MethodsWe retrospectively reviewed the clinical data of 18 children with AST treated at our hospital between January 2009 and May 2022.ResultsThere were 8 boys and 10 girls, aged 7.8 ± 3.8 years at admission. The main clinical manifestations were fever (88.9%), neck pain (100%), and neck mass (100%). Blood and pus cultures were performed in 9 and 15 patients, respectively. All blood cultures were negative, while positive pus cultures were noted in eight cases (six Streptococcus spp., one Staphylococcus spp., and one Streptococcus spp. and Staphylococcus spp. mixed infection). Additionally, all patients received antibiotic treatment: three received antibiotics alone, seven received antibiotics and ultrasound (US)-guided needle aspiration, seven received antibiotics as well as surgical incision and drainage, and one received antibiotics, US-guided needle aspiration in addition to surgical incision and drainage. Consequently, the average length of hospital stay in patients who received antibiotics and US-guided needle aspiration was 9.1±2.9 days compared to 14.0±2.0 days in patients in the antibiotics alone group and 13.0 ± 2.2 days in patients in the antibiotics and surgical incision and drainage group. Follow-up was conducted in 15 of the 18 patients. Three patients relapsed, and the prognosis of the other patients was good.ConclusionAST has atypical clinical symptoms at the early stage. Regular monitoring of the thyroid gland using ultrasonography is strongly advised in unsure cases. Antibiotics combined with US-guided aspiration is a safe, effective, and minimally invasive treatment for AST in children and can reduce hospital stay. However, surgery may be necessary, particularly in the presence of complications. It is strongly recommended that patients with recurrence be examined for anatomical abnormalities and undergo radical treatment.

Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children

Abnormalities of the third branchial arch are less common than those of the second arch and usually present with left thyroid lobe inflammation. This paper describes 15 cases of pyriform sinus fistulae of third branchial arch origin usually presenting as recurrent thyroid abscess on the left side. A retrospective review of 15 cases of third arch fistulae managed 2000 and 2008, diagnosed based on histopathology and radiological evidence of a fistulous tract, and treated with fistulectomy with left hemithyroidectomy. All patients (six boys and nine girls, aged three to 15 years) presented with recurrent low neck inflammation. Pre-operative ultrasound, computed tomography fistulography and barium swallow demonstrated a third arch fistulous tract, left-sided in all cases. The fistula was detected intra-operatively and pathologically in all cases. Surgery (successful in all cases) emphasised complete recurrent laryngeal nerve and ipsilateral pyriform sinus exposure, to facilitate tract excision, with left hemithyroidectomy. There was no recurrence over three to five years' follow up. Paediatric recurrent low neck inflammatory episodes, due to thyroidal abscess, especially left-sided, should raise suspicion of pyriform sinus fistulae.

Microbiology and management of acute suppurative thyroiditis in children

This review describes the microbiology, diagnosis and management of suppurative thyroiditis (ST). Staphylococcus aureus, Streptococcus pyogenes, Streptococcus epidermidis, and Streptococcus pneumoniae, are the predominant aerobic isolates. The most common anaerobic bacteria are Gram-negative bacilli and Peptostreptococcus spp. Agents that are rarely recovered include Klebsiella spp., Haemophilus influenzae, Streptococcus viridans, Salmonella spp., Enterobacteriaceae, Mycobacterium tuberculosis, atypical mycobacteria, Aspergillus spp., Coccidioides immitis, Candida spp., Treponema pallidum, and Echinococcus spp. Viruses have been associated with subacute thyroiditis, and include measles, mumps, influenza, enterovirus Epstein-barr, adenovirus, echovirus, and St Louis encephalitis. Therapy includes administration of antibiotics effective against the causative pathogen(s). Proper selection of therapy can be guided by culture of the lesion. Surgical drainage may be necessary in case of suppuration.

Acute suppurative thyroiditis in children.

Acute suppurative thyroiditis in children is rare and is often related to a pyriform sinus fistula or thyroglossal duct remnant, especially when it is recurrent. From January, 1985, through December, 2000, 15 children with acute suppurative thyroiditis were treated. Their clinical, laboratory and radiologic findings were reviewed and analyzed. There were 8 girls and 7 boys, with a mean age at diagnosis of 6.1+/-2.9 years (range, 1.5 to 9.8). A thyroid mass was present on the left in 13 and on the right in 2 (P < 0.05). Fever, neck pain and swelling were the most common symptoms and signs. Seven patients (46.7%) had recurrent disease. Needle aspiration for Gram stain and bacterial cultures were done, and pathogenic organisms were identified on culture in 8 patients but were found only on Gram stain in 2 patients. In one-half of the patients with positive cultures, mixed pathogens were found. The most common organisms isolated were streptococcal species (50%). Barium esophagography was performed in all patients, and 5 (33.3%) had a pyriform sinus fistula on the left. Only 1 of the recurrent patients had a fistula. Thyroid scans were performed in 13 patients, of whom 12 (92.3%) had decreased radioactive uptake. Thyroid function tests were normal in all 15. Acute suppurative thyroiditis is usually caused by oropharyngeal flora, resulting in mixed pathogens on culture. Broad spectrum antibiotics should be given once cultures have been obtained. Imaging studies might be helpful in the diagnosis of acute suppurative thyroiditis.

The role of ultrasound and oesophagography in the management of acute suppurative thyroiditis in children associated with congenital pyriform fossa sinus

The thyroid is remarkably resistant to infection. Hence, when an infection does occur, the presence of a pyriform fossa sinus must be considered, particularly if it is recurrent and left sided. The aim of this paper is to alert radiologists to the existence, clinical presentation, and ultrasonographic and oesophagographic appearances of a pyriform fossa sinus. We present the role of ultrasound and oesophagography in five children with pyriform fossa sinus associated with suppurative thyroiditis. In four children the abnormality was on the left and on the right in one.

Acute suppurative thyroiditis in children

Acute suppurative thyroiditis in children

Acute Suppurative Thyroiditis in Children

Acute Suppurative Thyroiditis in Children

Acute suppurative thyroiditis in children

Ten cases of acute suppurative thyroiditis were studied. All patients remained euthyroid clinically during the course of this disease and during the follow-up. Of seven cases in which bacterial cultures were performed, an aerobic bacterium alone was isolated in one patient and anaerobic bacteria alone in four patients. Mixed aerobic and anaerobic microorganisms were recovered from one patient and cultures were negative in one case. Plasma TSH, T4, T3, and PBI levels were normal except in one case. The 131I uptake values were normal in six of seven cases. Plasma TSH response to TRH stimulation was normal in four of five cases. Antibodies against thyroglobulin and thyroid microsome were negative in four of six cases. These findings suggest that anaerobic bacteria may play an important role in the pathogenic process of acute suppurative thyroiditis and that the pituitary-thyroid functions are not impaired.

Acute Suppurative Thyroiditis

In a recent article in Pediatrics, by Kirkland et al.,1 reference is made to only 36 cases of acute suppurative thyroiditis in children. Two years ago we made a review of the literature due to two unusual cases evaluated by us, one is a 1½-year-old Negro Dominican boy2 who presented two recurrent episodes of acute suppurative thyroiditis and a 7-year-old Puerto Rican girl who presented acute suppurative strumitis, for she suffered from chronic lymphocytic thyroiditis with superimposed suppuration.