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Related Experiment Videos

Acute suppurative thyroiditis after fine-needle aspiration causing thyrotoxicosis.

Eijun Nishihara1, Akira Miyauchi, Fumio Matsuzuka

  • 1Kuma Hospital, Kobe, Japan. nishihara@kuma-h.or.jp

Thyroid : Official Journal of the American Thyroid Association
|November 11, 2005
PubMed
Summary

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A rare case of thyrotoxicosis due to acute suppurative thyroiditis after repeated fine-needle aspiration (FNA) highlights infection risks. Special precautions are needed for patients with atopic dermatitis undergoing FNA to prevent bacterial contamination.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Thyroid nodules and cysts are common, often evaluated with fine-needle aspiration (FNA).
  • Complications from FNA are rare but can include infection.
  • Atopic dermatitis is associated with skin barrier defects and increased susceptibility to bacterial colonization.

Observation:

  • A 39-year-old woman with atopic dermatitis developed acute suppurative thyroiditis with thyrotoxicosis after a third FNA of a thyroid cyst.
  • Clinical presentation included fever, painful thyroid swelling, and elevated thyroid hormone levels.
  • Ultrasound revealed a thyroid abscess, with cytologic examination showing neutrophils and Staphylococcus aureus culture.

Findings:

  • The patient's condition did not improve with a month of antibiotic therapy.

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  • Surgical intervention (left thyroid lobectomy) was required for resolution of inflammation and normalization of thyroid function.
  • Needle-track seeding of Staphylococcus aureus, facilitated by atopic dermatitis-related immunodeficiency, is the suspected cause of infection.

    • Implications:

    • Fine-needle aspiration is a valuable diagnostic tool for thyroid lesions.
    • Physicians must exercise increased caution during FNA in patients with atopic dermatitis to mitigate infection risk.
    • This case underscores the importance of considering iatrogenic infection in thyroiditis, particularly in immunocompromised or susceptible patient populations.