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Two Cases of Bacterial Suppurative Thyroiditis Caused by Streptococcus anginosus

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Acute suppurative thyroiditis (AST) is a rare clinical condition. Streptococcus anginosus has a propensity of producing empyema in the head and neck. Here, we reported two cases of AST caused by S. anginosus. A 44-year-old man presented with anterior neck tender swelling and odynophagia for 12 days. He had thyrotoxicosis. He was initially diagnosed as thyroid cancer due to the misleading computed tomography report. Fine needle aspiration (FNA) yielded pus and neutrophils. S. anginosus was isolated from pus. After aspiration of abscess and treatment with sensitive antibiotics, he recovered uneventfully with 3 weeks treatment. He was euthyroid 3 months later. The other case is a 40-year-old women complained of fever and left neck swelling for 20 days. Magnetic resonance imaging showed left neck inflammatory changes. FNA revealed pus and inflammatory cells infiltration. She had moderately decreased level of thyroid-stimulating hormone (TSH). Blood cultures were positive for S. anginosus. After penicillin treatment, TSH level returned to normal range, and the nodule gradually resolved. She recovered uneventfully after 5 weeks treatment. S. anginosus has a previously unappreciated clinical niche in AST. Once AST is clinically concerned, FNA procedure should be performed as early as possible.

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References

  1. Mollar-Puchades MA, Camara-Gomez R, Perez-Guillen V, Benavides-Gabernet M, Gomez-Vela J, Pinon-Selles F. Thyroid hematoma and infectious thyroiditis after a neck injury. Thyroid 16:421–422, 2006.

    Article  PubMed  CAS  Google Scholar 

  2. Miyauchi A. Thyroid gland: a new management algorithm for acute suppurative thyroiditis? Nat Rev Endocrinol 6:424–426, 2010.

    Article  PubMed  Google Scholar 

  3. Paes JE, Burman KD, Cohen J, Franklyn J, McHenry CR, Shoham S, Kloos RT. Acute bacterial suppurative thyroiditis: a clinical review and expert opinion. Thyroid 20:247–255, 2010.

    Article  PubMed  Google Scholar 

  4. Siegman-Igra Y, Azmon Y, Schwartz D. Milleri group streptococcus-a stepchild in the viridans family. Eur J Clin Microbiol Infect Dis. 31:2453–2459, 2012.

    Article  PubMed  CAS  Google Scholar 

  5. Spitzer M, Alexanian S, Farwell AP. Thyrotoxicosis with post-treatment hypothyroidism in a patient with acute suppurative thyroiditis due to porphyromonas. Thyroid 22:97–100, 2012.

    Article  PubMed  Google Scholar 

  6. Miyauchi A, Inoue H, Tomoda C, Amino N. Evaluation of chemocauterization treatment for obliteration of pyriform sinus fistula as a route of infection causing acute suppurative thyroiditis. Thyroid 19:789–793, 2009.

    Article  PubMed  Google Scholar 

  7. Masuoka H, Miyauchi A, Tomoda C, Inoue H, Takamura Y, Ito Y, Kobayashi K, Miya A. Imaging studies in sixty patients with acute suppurative thyroiditis. Thyroid 21:1075–1080, 2011.

    Article  PubMed  Google Scholar 

  8. Park E, Hirsch EM, Steinberg JP, Olsson AB. Ascending necrotizing fasciitis of the face following odontogenic infection. J Craniofac Surg 23:e211-214, 2012.

    Article  PubMed  Google Scholar 

  9. Dunham B, Nicol TL, Ishii M, Basaria S. Suppurative thyroiditis. Lancet 368:1742,2006.

    Article  PubMed  Google Scholar 

  10. Yolmo D, Madana J, Kalaiarasi R, Gopalakrishnan S, Kiruba Shankar M, Krishnapriya S. Retrospective case review of pyriform sinus fistulae of third branchial arch origin commonly presenting as acute suppurative thyroiditis in children. J Laryngol Otol 126:737–742, 2012.

    Article  PubMed  CAS  Google Scholar 

  11. Gopan T, Strome M, Hoschar A, Zimmerman RS. Recurrent acute suppurative thyroiditis attributable to a piriform sinus fistula in an adult. Endocr Pract 13:662–666, 2007.

    PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the General Program (Key Program, Major Research Plan) of National Natural Science Foundation of China (81230007) and National Natural Science Foundation of China (81200147).

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The authors declare that no competing financial interests exist.

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Authors and Affiliations

  1. Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China

    Chaoneng Wu, Yiqi Zhang, Yunguo Gong, Yunzeng Zou & Junbo Ge

  2. Department of Pathology; Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032, China

    Yingyong Hou & Siyao Li

  3. Institute of Biomedical Science, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China

    Chaoneng Wu, Yiqi Zhang, Yunzeng Zou & Junbo Ge

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  1. Chaoneng Wu
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  2. Yiqi Zhang
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  3. Yunguo Gong
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  4. Yingyong Hou
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  5. Siyao Li
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  6. Yunzeng Zou
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Correspondence to Yunzeng Zou or Junbo Ge.

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Wu, C., Zhang, Y., Gong, Y. et al. Two Cases of Bacterial Suppurative Thyroiditis Caused by Streptococcus anginosus . Endocr Pathol 24, 49–53 (2013). https://doi.org/10.1007/s12022-013-9236-0

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  • DOI: https://doi.org/10.1007/s12022-013-9236-0

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