Case Of Acute Suppurative Thyroiditis Research Articles

Thyrotoxicosis as a rare presentation in acute suppurative thyroiditis: a case report

BackgroundAcute suppurative thyroiditis is a rare and potentially life-threatening disease. A few cases of acute suppurative thyroiditis associated with thyrotoxicosis have been reported in adults. We report a case of acute suppurative thyroiditis that was associated with thyrotoxicosis.Case presentationWe report the case of a 49-year-old Iranian female presented with a painful neck swelling for a week. Computed tomography showed a well-defined gas-filled collection in the left thyroid lobe with an enhancing margin. The patient underwent two-phase surgery, first left thyroid abscess drainage and then total thyroidectomy. The result of histopathology examination was multinodular goiter with abscess formation without malignancy.ConclusionAbscess formation and thyrotoxicosis is a very rare condition that occurs at the same time in acute suppurative thyroiditis. Despite antibiotic therapy being the first line of treatment, surgery is also required when antibiotic therapy fails.

亜急性甲状腺炎との鑑別を要した深頸部膿瘍例

Various factors cause deep neck abscesses. Severe cases can develop the complication of internal jugular vein thrombosis. Acute suppurative thyroiditis is one of the most common causes of deep neck abscess. Most cases arise from a hypopharyngeal pyriform sinus fistula, and the abscess is often on the left side of the neck. We report a case of acute suppurative thyroiditis developing from the right lobe of the thyroid that was complicated by internal jugular vein thrombosis.

Metastatic Thyroid Abscess: A Rare Presentation of Catheter-related Bloodstream Infection in an End-Stage Kidney Disease Patient on Hemodialysis.

Dear Editor, Over two-third of patients initiated on hemodialysis (HD) in India have temporary catheters as the initial venous access.[1] Bloodstream infections caused by infection of the catheters can lead to metastatic complications like infective endocarditis and septic arthritis.[2] We report a case of acute suppurative thyroiditis in an end-stage kidney disease (ESKD) patient with a history of prolonged use of non-tunneled catheter. A 35-year-old male had been undergoing HD through a right internal jugular non-tunneled catheter for three months. He presented to us with complaints of high fever, chills and rigors, swelling of the neck, and dysphagia for 10 days. Local examination revealed a large, tender, warm, and fluctuant anterior neck mass [Figure 1a].Figure 1: (a) A patient having diffuse painful neck swelling on admission. (b) Contrast-enhanced computed tomography of the neck showing multiple hypodense collections in both lobes of the thyroid and extending to the retropharyngeal space. (c) Resolution of swelling of the same patient after treatmentContrast-enhanced computed tomography of the neck revealed multiple loculated hypodense collections, approximating around 90 cc and showing enhancement of walls and septa in both lobes of the thyroid: these were suggestive of acute suppurative thyroiditis [Figure 1b]. Blood cultures sent from the catheter, peripheral blood, and pus culture from the thyroid abscess grew methicillin-resistant Staphylococcus aureus (MRSA). Henceforth, a diagnosis of metastatic thyroid abscess secondary to catheter-related bloodstream infection was considered. The catheter was removed followed by ultrasound-guided drainage of the abscess and antibiotics as per culture sensitivity. There was complete resolution of the abscess [Figure 1c]. Metastatic infections have been observed in approximately 5%–10% of patients undergoing HD through central venous catheters.[3] The tough capsule, high iodine content, and good lymphatic drainage make the thyroid gland resistant to infections.[4] We could find only one other case[5] that reported acute suppurative thyroiditis in an ESKD patient. CRBSI presenting as thyroid abscess is extremely rare and should always be suspected in any HD patient with painful neck swelling. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

急性化膿性甲状腺炎から食道穿孔を伴う深頸部感染症を来した症例

急性化膿性甲状腺炎から食道穿孔を伴う深頸部感染症を来した症例

A case of acute suppurative thyroiditis that was difficult to differentiate from subacute thyroiditis

A case of acute suppurative thyroiditis that was difficult to differentiate from subacute thyroiditis

Acute Suppurative Thyroiditis Secondary to Escherichia coli Infection.

Infections of the thyroid gland are rare. Its innate resistance to infections can be attributed to its unique anatomical features and rich blood supply. High clinical suspicion is required as a delay in diagnosis can lead to significant morbidity and mortality. Major pathogens include the Gram-positive Staphylococcus aureus and Streptococcus species; however, Gram-negative organisms have been found especially in immunocompromised hosts. We present a rare case of acute suppurative thyroiditis (AST) secondary to Escherichia coli (E. coli) infection in a woman known to be infected with human immunodeficiency virus (HIV).LEARNING POINTSThyroid abscesses are rare and can be confused with more common pathologies involving the neck such as a goitre, adenoma, intracystic haemorrhage, pharyngeal abscess and subacute thyroiditis.A high index of suspicion for a thyroid abscess is required for patients who present with an anterior neck swelling to avoid a late diagnosis, which is associated with significant morbidity and mortality.Acute suppurative thyroiditis is more commonly caused by Gram-positive organisms. Gram-negative organisms such as E. coli remain a rare cause. However, if a thyroid abscess is suspected clinically, broad-spectrum antibiotics can be lifesaving before definite culture and sensitivity results are available.

Methicillin-Sensitive Staphylococcus aureus Suppurative Thyroiditis with Thyrotoxicosis

Intravenous drug use (IVDU) can lead to numerous complications from skin abscesses to bacteremia to endocarditis. Here, we present a rare case of acute suppurative thyroiditis as a complication of IVDU, in which a 26-year-old female with a past medical history of IVDU presented to the emergency department for evaluation of a large right sided neck mass. On exam, she had signs of sepsis and thyrotoxicosis. Fine needle aspiration confirmed suppurative thyroiditis. Blood cultures and culture from fine needle aspiration grew Staphylococcus aureus. Patient was treated with 2 weeks of intravenous antibiotics with good resolution of her symptoms.

Thyrotoxicosis Due To Acute Suppurative Thyroiditis In A Postpartum Woman

ABSTRACT Objective: Postpartum thyroiditis is usually painless, is typically accompanied by thyrotoxicosis, and has an autoimmune pathogenesis. Here we present a case of acute suppurative thyroiditis with thyrotoxicosis in a postpartum woman. Methods: The following is a case report with a review of the literature. Results: A 24-year-old female, 5 months postpartum, presented with neck pain, palpitations, and fevers for 2 weeks. One month prior to presentation, she was treated with amoxicillin and prednisone for strep throat, with persistent symptoms. Blood pressure was 141/86 mm Hg and heart rate was 135 beats per minute. Examination revealed thyromegaly with a palpable, tender left thyroid nodule. Labs revealed low thyroid stimulating hormone (0.13 μIU/mL), elevated free thyroxine (2.04 ng/dL), and leukocytosis. Thyroid antibodies were normal. Thyroid ultrasound revealed a 3.4-cm complex nodule found to be hypofunctioning on a technetium pertechnetate scan. Computerized tomography of her neck showed an e...

A Case of Acute Suppurative Thyroiditis Accompanied by Transient Abducens Nerve Palsy

ABSTRACT Objective: This article reports the case of a 66-year-old female that developed right abducens nerve palsy 1 week after the onset of acute suppurative thyroiditis on her left side. Recurrent laryngeal nerve palsy has not been previously reported in a patient with acute suppurative thyroiditis and abducens nerve palsy. Methods: A medical examination of the patient revealed abnormal eye movements but no other abnormal neurological findings. Warmth, redness, and tenderness in the left anterior neck were noted along with right abducens nerve palsy. Laboratory data suggested a bacterial infection. Serum thyroid hormone and thyroglobulin concentrations were elevated. Computed tomography demonstrated unclear edematous changes together with the presence of air noted on the left side of the upper thyroid. Results: The patient was treated with an empiric broad-spectrum antibiotic and her suppurative thyroiditis improved. Two months after therapy, the right abducens nerve palsy improved without additional t...

One case of acute suppurative thyroiditis

One case of acute suppurative thyroiditis

A Case of Acute Suppurative Thyroiditis Complicated by Hypocalcemia

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Erratum: A Case of Acute Suppurative Thyroiditis Complicated by Hypocalcemia

Erratum: A Case of Acute Suppurative Thyroiditis Complicated by Hypocalcemia

Evaluation profile of thyroid nodule by fnac in the rural population of khanpur kalan, sonepat, haryana.

Thyroid disease is most common endocrine disorder and is different from other endocrine diseases because of its visible swelling and ease of diagnosis. If left untreated, thyroid disease makes a person more prone for heart disease, infertility and osteoporosis. In India, significant burden of thyroid diseases exist with an estimation of around 42 million cases. The thyroid status and autoimmune status of adult Indian population in the post iodinization phase is largely unknown. The main objective of this study was to generate valuable epidemiological data regarding the prevalence of thyroid disorders in rural population of Khanpur Kalan, Sonepat in the post-iodinisation era in India. To assess whether thyroid autoimmunity or goitrogens along with environmental factors play role in the development of thyroid.This paper is being presented in view that no such study has been carried out in the rural population of this region in Haryana. The present study was conducted in Department of Pathology, Bhagat Phool Singh Medical College for Women, Khanpur Kalan, Sonepat between August 2011 to July 2013. It included retrospective analysis of cytomorphology of fine needle aspiration cytology material of 206 patients presenting with thyroid nodule in the Department of Pathology. The commonest age group affected was 31-40 yrs. The female patients (93.4%) outnumbered the male patients (6.6%).The cytomorphological analysis of 206 patients revealed 190 cases (92.2%) of neoplastic lesions, 10 cases (4.8%) were neoplastic and 6 cases (2.9%) had indeterminate cytomorphology. Maximum number (65.5%) of patients was suffering with goiter followed by lymphocytic thyroiditis (26.2%). Amongst the malignant cases three cases were of papillary carcinoma and one case of medullary carcinoma. Two out of the six cases of follicular neoplasm proved to be follicular adenoma on histopathology. Four patients with high T3 levels were under treatment with neomercazole. They showed change in cytomorphology from hyperplasia to colloid goiter. Only one case of acute suppurative thyroiditis was reported which shows rarity of its type. The increased prevalence of goiter in this post iodinisation era can be attributed to goitrogens, autoimmune thyroid disease and micronutrient deficiency of iron and selenium. Higher prevalence of autoimmune thyroiditis in females is linked with both genetic and environmental factors such as infection, stress.

Campylobacter jejuni as a Cause of Acute Infectious Thyroiditis, on a Background of SLE-related End Stage Renal Failure and CMV Viraemia: A Case Report and Review of the Literature

Acute suppurative thyroiditis is a rare cause of thyroid disease; however it is capable of causing widespread systemic illness, with catastrophic complications. A large number of causative pathogens have been identified, the most common being Staphylococcus and Streptococcal species. We report a rare case of acute suppurative thyroiditis, caused by Campylobacter jejuni in a patient with systemic lupus erythematosus-related end-stage renal failure and excessive CMV viraemia. She developed severe respiratory compromise and required emergency total thyroidectomy and central neck clearance, which cured the local septic focus. The patient died from refractory sepsis due to E. coli.

A Case of Acute Suppurative Thyroiditis with Thyrotoxicosis in an Elderly Patient

Acute suppurative thyroiditis (AST) is a rare condition, as the thyroid gland is relatively resistant to infection. Thyroid function tests are usually normal in AST. A few cases of AST associated with thyrotoxicosis have been reported in adults. We report a case of AST that was associated with thyrotoxicosis in a 70-year-old woman. We diagnosed AST with thyroid ultrasonography and fine needle aspiration of pus. The patient improved after surgical intervention and had no anatomical abnormality. Fine needle aspiration is the best method for the difficult task of differentiating malignancy and subacute thyroiditis from AST with thyrotoxicosis. Earlier diagnosis and proper treatment for AST might improve the outcome.

A Case of Acute Suppurative Thyroiditis in a Patient with Leukemia Who was Treated with Chemotherapy

Acute suppurative thyroiditis (AST) is a rare disease of the thyroid gland that results from anatomical abnormalities, such as pyriform sinus fistula. However, in some case reports, patients with AST did not have anatomical abnormalities, including a report in which children with acute leukemia developed AST after chemotherapy. We report a case of AST in an adult with a hematologic disorder treated with chemotherapy. Although he was initially treated with parenteral antibiotics, surgical intervention was performed due to progressive worsening of AST. He recovered after surgical intervention and had no anatomical abnormality. (J Korean Endocr Soc 24:38~41, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Acute Suppurative Salmonella Thyroiditis in a Patient With Graves Disease and Fluoroquinole Resistance

A 31-year-old woman with a history of hyperthyroidism presented with acute swelling of the goiter. Subsequent thyroid aspirate grew fluoroquinolone-resistant Salmonella enterica serotype choleraesuis. The patient was treated with parental antibiotics and surgical drainage. No evidence of a pyriform sinus fistula was found. The source and route of infection remained unidentified. Infections of the thyroid are rare but potentially life-threatening. Salmonella-induced suppurative thyroiditis is very rare. We report this unusual case of acute suppurative thyroiditis caused by S choleraesuis in an immunocompetent middle-aged woman with a history of hyperthyroidism.

Acute Suppurative Thyroiditis with Deep Neck Infection: A Case Report

Thyroid gland suppuration is a rare condition with nonspecific features. For this reason, diagnosis is often delayed, which may lead to a life-threatening situation. Causative agents are often gram-positive bacteria, such as Staphylococcus aureus and Streptococcus pneumoniae. With appropriate antibiotics and drainage of the abscess, the prognosis is usually excellent. Herein, we describe a unique case of acute suppurative thyroiditis in an adult male presenting with nonspecific sore throat after a fish bone injury to the throat. The patient had a history of essential hypertension and gouty arthritis. In the emergency room, fever, chills, and neck swelling were noted. Thyroid echo and computed tomography of the neck revealed the thyroid abscess with deep neck infection. The culture of the abscess showed Streptococcus viridans. He recovered gradually after parenteral antibiotics and surgical intervention.

A case of acute suppurative thyroiditis complicated by thyrotoxicosis

Acute suppurative thyroiditis is a very uncommon disorder, most often arising in children with congenital conditions connecting the thyroid directly to the oropharynx, such as a piriform fistula or thyroglossal duct. Accordingly, the most common causative agents are those which can colonize the oral mucosa and spread to the thyroid contiguously, such as Streptococcus species, Staphylococcus species and anerobes. In adults, a hematogenous spread to a pre-existing altered thyroid gland is often the postulated pathogenetic mechanism, and it is exceedingly rare in the United States. We report the case of an 81-yr-old woman with acute suppurative thyroiditis secondary to Escherichia coli (E. coli) infection. The patient presented with fevers, chills, dysuria and recent painful neck swelling. Thyroid ultrasound and neck computed tomography revealed a multinodular goiter and an intra-thyroid abscess. An otolaryngology evaluation and barium swallow failed to show a piriform fistula. Thyroid hormone levels were consistent with hyperthyroidism. Urine cultures were positive for E. coli. The patient subsequently developed a clinical picture consistent with severe thyrotoxicosis, which rapidly resolved after medical treatment, appropriate antibiotics and surgical drainage of the thyroid. Abscess material also grew E. coli. Thus, acute suppurative thyroiditis secondary to sepsis can complicate an otherwise asymptomatic multinodular goiter and should be promptly treated with broad-spectrum antibiotics and/or surgical drainage to avoid serious consequences, including severe thyrotoxicosis.

サルモネラによる急性化膿性甲状腺炎例

Acute suppurative thyroiditis due to salmonella is an extremely rare condition because the thyroid gland is totally encapsulated and has a high local iodide content, with a rich lymphatic and vascular supply. We report a case of acute suppurative thyroiditis in a 50-year-old woman. She presented with a painful swelling in the left neck. She had neither symptom nor history of gastroenteritis. Ultrasound examination of the thyroid suggested an abscess of the inferior pole of the left thyroid lobe. Purulent fluid obtained by fine needle puncture grew Salmonella Anatum. The abscess got worse despite the intravenous administration of antibiotics, and surgical drainage was performed. No evidence of piriform sinus fistula was found in barium swallowing examinations two and five months after surgery. Although the route of infection remained unclear, a hematogenous route seemed to be the most likely.