Endocrine Emergencies pp 109-113 | Cite as
Acute Suppurative Thyroiditis
Abstract
Acute suppurative thyroiditis is a medical emergency that usually presents with anterior neck pain, fever, and dysphagia and can lead to airway obstruction. Thyroid infection is rare, and an underlying immune deficiency or thyroid abnormality is present in most cases. The majority of immunocompetent patients will have a pyriform sinus fistula. Differentiating acute suppurative thyroiditis from painful subacute thyroiditis or invasive head and neck infections usually requires diagnostic imaging with CT or ultrasound. In certain instances, tissue histology obtained by fine needle aspiration may be required to definitively diagnose acute suppurative thyroiditis. Obtaining cultures by aspiration, surgery, or percutaneous drainage is required to guide antibiotic therapy. The majority of acute suppurative thyroiditis cases are caused by Staphylococcus aureus and Streptococcus species. Acute suppurative thyroiditis should be treated urgently with antibiotics and abscess drainage.
Keywords
Thyroid Nodule Abscess Drainage Pyriform Sinus Neck Infection Subacute ThyroiditisReferences
- 1.Desailloud R, Hober D. Viruses and thyroiditis: an update. Virol J. 2009;6:5.PubMedCrossRefGoogle Scholar
- 2.Miyauchi A. Thyroid gland: A new management algorithm for acute suppurative thyroiditis? Nat Rev Endocrinol. 2010;6(8):424–6.PubMedCrossRefGoogle Scholar
- 3.Paes JE, Burman KD, Cohen J, et al. Acute bacterial suppurative thyroiditis: a clinical review and expert opinion. Thyroid. 2010;20(3):247–55.PubMedCrossRefGoogle Scholar
- 4.Smith SL, Pereira KD. Suppurative thyroiditis in children: a management algorithm. Pediatr Emerg Care. 2008;24(11):764–7.PubMedCrossRefGoogle Scholar
- 5.Golshan MM, McHenry CR, de Vente J, Kalajyian RC, Hsu RM, Tomashefski JF. Acute suppurative thyroiditis and necrosis of the thyroid gland: a rare endocrine manifestation of acquired immunodeficiency syndrome. Surgery. 1997;121(5):593–6.PubMedCrossRefGoogle Scholar
- 6.Berger SA, Zonszein J, Villamena P, Mittman N. Infectious diseases of the thyroid gland. Rev Infect Dis. 1983;5(1):108–22.PubMedCrossRefGoogle Scholar
- 7.Lethert K, Bowerman J, Pont A, Earle K, Garcia-Kennedy R. Methicillin-resistant Staphylococcus aureus suppurative thyroiditis with thyrotoxicosis. Am J Med. 2006;119(11):e1–2.PubMedCrossRefGoogle Scholar
- 8.Al-Dajani N, Wootton SH. Cervical lymphadenitis, suppurative parotitis, thyroiditis, and infected cysts. Infect Dis Clin North Am. 2007;21(2):523–41, viii.PubMedCrossRefGoogle Scholar
- 9.Pearce EN, Farwell AP, Braverman LE. Thyroiditis. N Engl J Med. 2003;348(26):2646–55.PubMedCrossRefGoogle Scholar
- 10.Masuoka H, Miyauchi A, Tomoda C, et al. Imaging studies in sixty patients with acute suppurative thyroiditis. Thyroid. 2011;21(10):1075–80.PubMedCrossRefGoogle Scholar