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Infective thyroiditis in northern Nigeria: a fifteen-year study
Abstract:
Infective (suppurative) thyroiditis is almost non-existent in the developed world and even in the developing world, it still remains a rare disease entity. Seventeen patients with this disease were seen in 15 years in Zaria, Northern Nigeria. Fourteen of these patients had multinodular goitre, one patient had an adenoma and 2 never had a pre-existing neck swelling. Two patients with multinodular goitres had associated papillary and follicular carcinoma respectively. Pus was not obtained for culture from 3 patients. The pus in 5 (29%) of 17 patients grew staphylococcus aureus. 2 patients grew salmonella typhi and E. coli respectively and 2 patients grew Group A beta-haemolytic streptococcus from the pus. In three patients the diagnosis of thyroid abscess was an incidental finding by the pathologist, in patients with tender goitre clinically suspected to have had recent haemorrhages. Indolent thyroid abscesses from which gram negative organisms are isolated may be a pointer to an associated underlying malignancy.
Insights
Infective (suppurative) thyroiditis is a rare condition, even in developing nations. This study in Nigeria found Staphylococcus aureus as the most common pathogen, with some cases linked to underlying thyroid cancer.
Area of Science:
- Endocrinology
- Infectious Diseases
- Pathology
Background:
- Infective (suppurative) thyroiditis is exceptionally rare globally, with limited data from developing regions.
- This study focuses on the epidemiology and clinical presentation of this rare condition in Zaria, Northern Nigeria.
Purpose of the Study:
- To describe the clinical characteristics, causative organisms, and outcomes of infective thyroiditis in a Nigerian population.
- To investigate potential associations between infective thyroiditis and underlying thyroid pathology, including malignancy.
Main Methods:
- Retrospective review of 17 patients diagnosed with infective thyroiditis over 15 years.
- Analysis of patient demographics, pre-existing thyroid conditions, microbiological cultures, and histopathological findings.
Main Results:
- Seventeen cases of infective thyroiditis were identified, predominantly associated with multinodular goiter (14 patients).
- Staphylococcus aureus was the most frequent isolate (29%), followed by Salmonella typhi, E. coli, and Group A beta-haemolytic streptococcus.
- Two patients with multinodular goiters had concurrent papillary and follicular thyroid carcinoma. Three cases were incidental findings during pathology examination of presumed hemorrhagic goiters.
Conclusions:
- Infective thyroiditis, though rare, occurs in Nigeria, often linked to pre-existing goiters.
- The isolation of gram-negative organisms from indolent thyroid abscesses may indicate an underlying malignancy.
- Prompt diagnosis and appropriate management are crucial, considering potential associations with thyroid cancer.