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Recurrent acute suppurative thyroiditis in a child: case report

C F Hsu1, C C Wang, M C Tsai

  • 1Department of Pediatrics, Tri-Service General Hospital, and National Defense Medical Center, Taipei, Taiwan, ROC.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|September 25, 1999
PubMed

Insights

A pediatric neck mass and fever were treated with antibiotics and drainage. A persistent infection revealed a left pyriform sinus fistula, successfully treated surgically.

Area of Science:

  • Pediatric Infectious Diseases
  • Otolaryngology
  • Endocrinology

Background:

  • Pediatric neck masses can present with infectious symptoms.
  • Thyroid dysfunction may accompany infectious processes.

Observation:

  • A 23-month-old girl developed fever and a neck mass post-URI.
  • Initial treatment included drainage and antibiotics for suspected thyroiditis.
  • Recurrence of symptoms led to further investigation.

Findings:

  • Thyroid aspirate cultures grew mixed flora, including streptococci and Prevotella spp.
  • Elevated inflammatory markers (ESR, CRP) and impaired thyroid function were noted.
  • A left pyriform sinus fistula was identified as the underlying cause.

Implications:

  • Pyriform sinus fistula should be considered in pediatric neck infections, especially recurrent ones.
  • Multidisciplinary management involving infectious disease, surgery, and endocrinology is crucial.
  • Prompt diagnosis and surgical correction of congenital fistulas can prevent recurrent infections.

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