Purulent thyroiditis--a clinical study of 5 cases

Area of Science:

• Endocrinology
• Infectious Diseases
• Surgical Pathology

Background:

• Purulent thyroiditis is a rare condition that can mimic other thyroid pathologies, posing diagnostic difficulties.
• This study examines five cases of purulent thyroiditis diagnosed between 1990 and 2006, highlighting unusual clinical presentations.

Purpose of the Study:

• To describe the clinical characteristics, diagnostic challenges, and treatment outcomes of purulent thyroiditis.
• To emphasize the role of surgery in managing this condition.

Main Methods:

• Retrospective analysis of five patients diagnosed with purulent thyroiditis.
• Review of clinical data, imaging (ultrasound, scintigraphy), fine needle aspiration biopsy, and histopathological findings.
• Surgical treatment (subtotal thyroidectomy) and postoperative antibiotic therapy were administered.

Main Results:

• Patients presented with hard, heterogeneous, hypo-echogenic thyroid nodules, often mistaken for cancer.
• Infection was confirmed by purulent infiltration and bacterial/fungal identification (Staphylococcus, Streptococcus, Aspergillus).
• Surgical treatment and antibiotics led to complete recovery in all cases, with two requiring tracheostomy due to compression symptoms.

Conclusions:

• Purulent thyroiditis presents a significant diagnostic challenge due to its varied and often atypical presentation.
• Surgical management, including thyroidectomy and abscess drainage, is crucial for effective treatment and faster patient recovery.