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Acute suppurative klebsiella thyroiditis: a case report
B Bukvic1, A Diklic, V Zivaljevic
1Centre for Endocrine Surgery, Institute for Endocrinology, Clinical Centre of Serbia, Belgrade, Serbia. bukvicbranka@gmail.com
Acta Chirurgica Belgica
|June 9, 2009
Summary
Acute suppurative thyroiditis, a rare condition, typically involves Gram-positive bacteria. This case highlights a unique right-lobe thyroid abscess caused by Klebsiella spp. in a diabetic patient.
Area of Science:
- Endocrinology
- Infectious Diseases
- Surgical Pathology
Background:
- Acute suppurative thyroiditis and thyroid abscess are rare endocrine emergencies.
- Gram-positive bacteria, such as staphylococci and streptococci, are the most common causative agents.
- Thyroid abscesses typically occur in the left thyroid lobe.
Observation:
- A 75-year-old female presented with acute suppurative thyroiditis and a right thyroid lobe abscess.
- Clinical examination revealed a firm, livid cervical swelling.
- Computed tomography confirmed a right thyroid lobe abscess and thyroid gland swelling.
Findings:
- Culture results identified Klebsiella spp. as the pathogen, an unusual cause.
- The patient had a history of diabetes mellitus and prior goiter surgery.
- Right vocal cord paralysis was noted on laryngoscopy.
Implications:
- This case underscores the possibility of unusual pathogens like Klebsiella in thyroid infections.
- Diabetes mellitus and previous thyroid surgery with non-absorbable sutures may predispose patients to such infections.
- Prompt diagnosis and treatment, including surgical drainage and antibiotics, are crucial for resolution, though complications like vocal cord paralysis may persist.
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