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[Acute suppurative thyroiditis. Report of a pediatric case]
Vinka Giadrosich1, M Isabel Hernández, Claudia Izquierdo
1Departamento de Pediatría, Universidad de Valparaíso. vinkag@vtr.net
Revista Medica De Chile
|September 29, 2004
Summary
Acute suppurative thyroiditis (AST) is a rare infection of the thyroid gland. This case highlights Streptococcus Pneumoniae as a cause in a pediatric patient, emphasizing prompt diagnosis and treatment.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Head and Neck Surgery
Background:
- Acute suppurative thyroiditis (AST) is infrequent due to the thyroid's inherent resistance to infection.
- Anatomical abnormalities, like pyriform sinus fistulas or thyroglossal duct remnants, are common predisposing factors in pediatric cases.
- Prompt diagnosis via imaging and targeted antimicrobial therapy guided by culture and Gram staining are crucial.
Observation:
- A 13-year-old female presented with neck pain and fever.
- Cervical ultrasound revealed an enlarged thyroid lobule with hypoechoic areas indicative of a suppurative collection.
- Empirical antibiotic treatment with cefotaxime and cloxacillin was initiated.
Findings:
- Needle aspiration yielded purulent material, with cultures identifying Streptococcus Pneumoniae.
- The patient demonstrated clinical improvement and was discharged in stable condition.
- Subsequent contrast esophagography two months post-treatment did not reveal any predisposing anatomical defects.
Implications:
- This case underscores the importance of considering AST in children with cervical infections, even with atypical presentations.
- Successful management relies on early diagnosis, appropriate antibiotic selection, and diligent follow-up to rule out underlying anatomical abnormalities.
- Further investigation into the specific mechanisms of thyroidal resistance and susceptibility to infection remains an area for research.