Pretracheal tuberculous abcess mimicking a thyroid swelling-A case report

Area of Science:

• Infectious Diseases
• Pulmonology
• Surgical Pathology

Background:

• Pretracheal tubercular abscess is an uncommon manifestation of extrapulmonary tuberculosis, even in tuberculosis-endemic regions.
• Typically, such abscesses involve the lymph nodes in the posterior triangle of the neck.

Purpose of the Study:

• To report a rare case of pretracheal tubercular abscess presenting as a lower midline neck swelling.
• To emphasize the importance of considering tuberculosis in the differential diagnosis of anterior neck masses.

Main Methods:

• A case report detailing a patient with a 6-month history of neck swelling and 1 month of dysphagia.
• Diagnosis was confirmed via radiological assessment, followed by abscess drainage and initiation of anti-tuberculosis treatment.

Main Results:

• The patient presented with a lower midline neck swelling and dysphagia.
• Radiological diagnosis confirmed a tuberculous abscess, which was successfully managed conservatively with drainage and medical treatment.

Conclusions:

• Anterior neck swellings, particularly in the anterior lymph node region, warrant a high degree of suspicion for tuberculosis in endemic areas.
• Accurate radiological assessment is crucial to differentiate tuberculous lymphadenopathy from other pathologies like thyroid nodules.
• Thorough pre-operative evaluation can prevent unnecessary major surgery for benign conditions such as tuberculosis.